Medical retina and Uveitis Service, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
Department of Neurosciences, Biomedicine and Movement Sciences, Eye Clinic, AOUI-University of Verona, Verona, Italy.
Br J Ophthalmol. 2022 Jan;106(1):121-127. doi: 10.1136/bjophthalmol-2020-317357. Epub 2020 Oct 21.
To report the demographics and the clinical course of patients with multiple evanescent white dot syndrome (MEWDS) and to investigate for those factors which influence visual acuity (VA) recovery.
This is a retrospective single-centre observational study. Electronic medical records and retinal imaging of patients with a diagnosis of MEWDS with a minimum follow-up of 3 months were reviewed. Patients were categorised into three groups according to the VA at presentation and at the last visit: group 1 >0.48 logarithm of the minimum angle of resolution (LogMAR), group 2 ≤0.48 and ≥0.18 LogMAR and group 3 <0.18 LogMAR. All patients had non-invasive multimodal imaging including optical coherence tomography, near-infrared reflectance imaging and blue fundus autofluorescence at presentation and during follow-up.
A total of 51 eyes from 51 patients (41 women, mean age 29.8±7.8 years) were included. Significantly more patients presented in the autumn (X=8.69, p=0.034). The percentage of eyes recovering vision to 0.0 LogMAR or better was 80.3% (41/51). Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA (p=0.002 and p=0.02, respectively). No imaging features were significantly predictive of complete versus incomplete recovery, but disc hyperfluorescence on fluorescein angiography was more common in those with incomplete recovery.
Although the majority of cases have a benign prognosis, the clinical spectrum of MEWDS includes incomplete visual recovery. In our series, poor presenting VA and young age were associated with poor VA outcome. Further study is warranted to confirm these findings.
报告多发性一过性白点综合征（MEWDS）患者的人口统计学和临床病程，并探讨影响视力（VA）恢复的因素。
这是一项回顾性单中心观察性研究。对至少随访 3 个月、诊断为 MEWDS 且有电子病历和视网膜图像的患者进行了回顾。根据就诊时和最后一次就诊时的 VA 将患者分为三组：第 1 组>0.48 对数最小角分辨率（LogMAR），第 2 组≤0.48 且≥0.18 LogMAR，第 3 组<0.18 LogMAR。所有患者均接受非侵入性多模态成像，包括就诊时和随访期间的光学相干断层扫描、近红外反射成像和蓝色眼底自发荧光。
共纳入 51 例患者（41 例女性，平均年龄 29.8±7.8 岁）的 51 只眼。秋季就诊的患者明显更多（X=8.69，p=0.034）。80.3%（41/51）的眼视力恢复至 0.0 LogMAR 或更好。就诊时视力较差和年龄较小是最终 VA 较差的独立显著预测变量（p=0.002 和 p=0.02）。没有影像学特征可显著预测完全恢复与不完全恢复，但荧光素血管造影时盘状高荧光更常见于不完全恢复者。
尽管大多数病例预后良好，但 MEWDS 的临床谱包括不完全的视力恢复。在我们的系列中，就诊时的 VA 较差和年龄较小与 VA 预后不良相关。需要进一步研究来证实这些发现。
