The multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy lesion with multiple evanescent white dot syndrome-like features: a retrospective study

BMC Ophthalmol. 2024 Jan 2;24(1):3. doi: 10.1186/s12886-023-03277-6.

Abstract

Background: Multiple evanescent white dot syndrome (MEWDS)-like features is a rare condition triggered by a macular disease or iatrogenic injury, exhibiting MEWDS changes in the fundus. This study aims to describe the multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy (MFC/PIC) lesions with MEWDS-like features.

Methods: Six cases were studied retrospectively. All cases were given regional and oral corticosteroids.

Results: All cases showed an isolated juxtafoveal yellowish-white MFC/PIC lesion with disruption of RPE-Bruch's membrane-choriocapillaris complex (RPE-BM-CC), subretinal hyperreflective materials and choroidal thickening on optical coherence tomography. Two weeks after presentation, the grayish-white dots disappeared spontaneously and the corticosteroids were given. After four weeks, the ellipsoid zone (EZ) around the lesion and hyper-autofluorescence resolved. After 13 weeks, five cases showed shrinkage of the juxtafoveal lesion and restoration of foveal EZ. After six months, the juxtafoveal lesion became pigmented. Only one case developed type 2 choroidal neovascularization.

Conclusions: The clinical course of MEWDS-like manifestations is still evanescent in our cases. The yellowish-white juxtafoveal MFC/PIC lesions with disruption of RPE-BM-CC and choroidal thickening showed a well-controlled prognosis after corticosteroid treatment.

This study is a retrospective case series to describe the multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy lesion with multiple evanescent white dot syndrome-like features.

Keywords: Choroidal neovascularization; Focal choroidal excavation; Multifocal choroiditis/punctate inner choroidopathy; Multimodal imaging; Multiple evanescent white dot syndrome.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Choroiditis* / diagnosis
  • Choroiditis* / drug therapy
  • Fluorescein Angiography / methods
  • Humans
  • Multifocal Choroiditis
  • Multimodal Imaging / methods
  • Retrospective Studies
  • Tomography, Optical Coherence / methods
  • White Dot Syndromes* / diagnosis

Substances

  • Adrenal Cortex Hormones