Multiple Evanescent White Dot Syndrome: A Multimodal Imaging Study of Foveal Granularity

ABSTRACT

Purpose: To describe multiple evanescent white dot syndrome (MEWDS)-related foveal granularity features on different imaging modalities.

Methods: Clinical and multi-imaging files from five patients affected by MEWDS were reviewed. Each image set included: blue fundus autofluorescence (BAF), near-infrared fundus autofluorescence (NIR-FAF), spectral-domain optical coherence tomography (SD-OCT), fluorescein (FA), and indocyanine green (ICGA) angiography. Foveal granularity features were analyzed and described for each technique at baseline and follow-up.

Results: At baseline, 4/5 patients did not show white dots at funduscopic examination, but all subjects demonstrated hypo-fluorescent lesions on ICGA and areas of increased BAF. In all patients, foveal granularity was detectable on NIR-FAF as an irregular hypo-fluorescent area, persisting during follow-up visits. The corresponding SD-OCT scans revealed outer retinal layers’ disruption resolving overtime.

Conclusions: Foveal granularity can be the sole presenting sign of MEWDS. NIR-FAF and SD-OCT should be considered as non-invasive investigations in the detection of MEWDS-related foveal granularity.

Keywords:

• Autofluorescence
• fovea granularity
• MEWDS
• optical coherence tomography
• uveitis

DECLARATION OF INTEREST

Dr. Invernizzi reports personal fees from Alcon (Novartis), other from Allergan, personal fees from Bayer, outside the submitted work. Dr. Staurenghi reports grants and personal fees from Novartis, grants and personal fees from Bayer, personal fees from Alcon, personal fees from Allergan, personal fees from Boeheringer, grants and personal fees from Genentech, personal fees from Roche, grants and personal fees from Centervue, grants and personal fees from Heidelberg Engineering, grants and personal fees from Zeiss Meditec, grants and personal fees from Optos, grants from Optovue, grants and personal fees from Quantel Medical, outside the submitted work. In addition, Dr. Staurenghi has a patent Ocular Instruments with royalties paid.

Drs. Mantovani and Herbort have nothing to disclose.

Funding

Dr. Giovanni Staurenghi has financial relationships with OCT manufacturers (Heidelberg Engineering, Zeiss, Nidek, Canon, Optovue).

Additional information

Funding

Dr. Giovanni Staurenghi has financial relationships with OCT manufacturers (Heidelberg Engineering, Zeiss, Nidek, Canon, Optovue).