Topographic patterns of retinal lesions in multiple evanescent white dot syndrome

Graefes Arch Clin Exp Ophthalmol. 2023 Aug;261(8):2257-2264. doi: 10.1007/s00417-023-06032-1. Epub 2023 Mar 29.

Abstract

Purpose: To demonstrate different topographic distributions of multiple-evanescent white dot syndrome (MEWDS) and secondary MEWDS disease and to describe possible associations.

Methods: Clinical evaluation and multimodal retinal imaging in 27 subjects with MEWDS (29 discrete episodes of MEWDS). Ophthalmic assessment included best-corrected visual acuity testing and multimodal retinal imaging with OCT, blue-light autofluorescence, fluorescein and indocyanine green angiography, fundus photography, and widefield pseudocolor and autofluorescence fundus imaging.

Results: The topographic distribution of MEWDS lesions was centered on or around the optic disc (n = 17, 59%), centered on the macula (n = 7, 24%), sectoral (n = 2, 7%), or was indeterminate (n = 3, 10%). The MEWDS episodes either occurred in the absence ('primary MEWDS'; n = 14, 48%) or presence of concurrent chorioretinal pathology ('secondary MEWDS'; n = 15, 52%). In patients with the latter, MEWDS lesions were often centered around a coexisting chorioretinal lesion. The majority of patients in both groups experienced resolution of their symptoms and retinal changes on multimodal imaging by 3 months.

Conclusions: Distinct distributions of MEWDS lesions were identified. MEWDS may occur in tandem with other chorioretinal pathology, which may impact the topography of MEWDS lesions.

Keywords: Angiography; Fundus autofluorescence; Multimodal imaging; Multiple evanescent white dot syndrome; Myopia; Optical coherence tomography.

MeSH terms

  • Fluorescein Angiography / methods
  • Humans
  • Retina
  • Retinal Diseases* / diagnosis
  • Tomography, Optical Coherence / methods
  • White Dot Syndromes* / diagnosis