Veronese Chiara, Maiolo Chiara, Morara Mariachiara, Armstrong Grayson W, Ciardella Antonio P
Ophthalmology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Pelagio Palagi 9, 40138, Bologna, Italy.
University of Bologna, Bologna, Italy.
Int Ophthalmol. 2018 Oct;38(5):2153-2158. doi: 10.1007/s10792-017-0673-5. Epub 2017 Aug 9.
To present a single case of bilateral multiple evanescent white dot syndrome (MEWDS).
A single case with three months of follow-up using imaging studies including fundus color photography (FP), fluorescein angiography (FA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT), en face SD-OCT and optical coherence tomography angiography (OCTA) is presented.
The patient presented with bilateral MEWDS, ultimately with complete resolution of symptoms. FP revealed foveal granularity and white punctate deep retinal spots, FA found early wreath-like hyperfluorescence, while ICGA showed hypofluorescent dots and spots in the early and late stages. FAF showed areas of hyperautofluorescence. SD-OCT revealed disruption of the ellipsoid zone (EZ) and accumulation of hyperreflective material of variable size and shape. En face SD-OCT demonstrated hyporeflective areas corresponding to areas of EZ disruption as well as hyperreflective dots in the outer nuclear layer. OCTA showed areas of photoreceptor slab black-out corresponding to areas of EZ disruption and light areas of flow void or flow disturbance in the choriocapillaris slab.
This case represents an unusual case of bilateral MEWDS with complete resolution within three months.
报告一例双侧多发性一过性白点综合征（MEWDS）。
报告一例患者，对其进行了为期三个月的随访，采用了包括眼底彩色照相（FP）、荧光素血管造影（FA）、吲哚菁绿血管造影（ICGA）、眼底自发荧光（FAF）、光谱域光学相干断层扫描（SD - OCT）、正面SD - OCT和光学相干断层扫描血管造影（OCTA）在内的影像学检查。
该患者表现为双侧MEWDS，最终症状完全缓解。FP显示黄斑部颗粒状改变及视网膜深层白色点状病灶，FA发现早期花环样高荧光，而ICGA在早期和晚期均显示低荧光点和斑。FAF显示高自发荧光区域。SD - OCT显示椭圆体带（EZ）破坏以及大小和形状各异的高反射物质积聚。正面SD - OCT显示与EZ破坏区域对应的低反射区域以及外核层中的高反射点。OCTA显示与EZ破坏区域对应的光感受器板层信号缺失区域以及脉络膜毛细血管板层中的血流缺失或血流紊乱的亮区。
该病例代表了一例不寻常的双侧MEWDS病例，在三个月内完全缓解。
