Purpose: To analyze the changes of macrophage-like cells (MLCs) on the inner retinal surface associated with multiple evanescent white dot syndrome using optical coherence tomography.
Methods: Four eyes of four patients with multiple evanescent white dot syndrome were examined and followed with multimodal imaging, including optical coherence tomography angiography, to visualize MLC on en face structural projections.
Results: On en face structural optical coherence tomography angiography projection at presentation, all multiple evanescent white dot syndrome eyes showed a decrease of the nearest neighbor distance of MLC within the region of interest and an increase of MLC density in the perifovea compared with the fellow unaffected eye. Three eyes demonstrated protrusion of MLC into the vitreous. At 1 to 3 months of follow-up, nearest neighbor distance increased, and MLC density decreased to the level of the fellow unaffected eye along with regression of multiple evanescent white dot syndrome symptoms.
Conclusion: Multiple evanescent white dot syndrome may be associated with increase of MLC population on the inner retinal surface, which can be tracked with clinical optical coherence tomography imaging.