Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy; Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Ophthalmol Retina. 2021 Oct;5(10):1017-1026. doi: 10.1016/j.oret.2020.12.007. Epub 2020 Dec 22.
To describe a clinical picture resembling classic multiple evanescent white dot syndrome (MEWDS) potentially triggered by previous or concurrent, apparently unrelated, ocular events and to provide a literature review of similar presentations.
Retrospective chart series and literature review.
Consecutive patients diagnosed with MEWDS at the Feinberg School of Medicine, Northwestern University, Chicago, Illinois, and the IRCCS San Raffaele Scientific Institute, Milan, Italy, between July 2019 and June 2020.
Charts of patients were reviewed. Ophthalmic history, best-corrected visual acuity, spectral-domain OCT results, OCT angiography results, fundus autofluorescence results, ultra-widefield fluorescein angiography results, and indocyanine green angiography results were collected. A PubMed-based search was carried out for similar presentations using the terms MEWDS and white spot syndromes.
An ocular history positive for previous or concurrent ocular events in patients with MEWDS was sought in our cohort and the existing literature.
Five eyes of 4 patients (2 females; age range, 16-81 years) were included. The first eye had a history of bilateral Best vitelliform dystrophy and unilateral choroidal neovascularization. The second eye had angioid streaks complicated by choroidal neovascularization and underwent prior thermal laser photocoagulation. The third eye had a history of high myopia and a scleral buckle procedure for retinal detachment. The fourth patient had bilateral idiopathic retinochoroiditis. We identified 16 case reports from 5 previous publications that support a MEWDS-like reaction to previous ocular insults.
We suggest a MEWDS-like reaction may be elicited by ocular events in a subset of susceptible patients. We hypothesize that damage to the outer retina may play a role in triggering the local inflammatory response.
描述一种类似于经典多发性一过性白点综合征（MEWDS）的临床症状，其可能由先前或同时发生的、看似无关的眼部事件引发，并对类似表现进行文献复习。
回顾性图表系列和文献复习。
2019 年 7 月至 2020 年 6 月，在美国伊利诺伊州芝加哥西北大学范伯格医学院和意大利米兰的圣拉斐尔科学研究所，连续诊断为 MEWDS 的患者。
对患者的图表进行了回顾。收集了眼科病史、最佳矫正视力、谱域 OCT 结果、OCT 血管造影结果、眼底自发荧光结果、超广角荧光素血管造影结果和吲哚青绿血管造影结果。使用 MEWDS 和白点综合征等术语，在 PubMed 上进行了类似表现的搜索。
在我们的队列和现有文献中，寻找 MEWDS 患者有先前或同时存在的眼部事件的眼部病史。
4 名患者（2 名女性；年龄范围 16-81 岁）的 5 只眼纳入研究。第一只眼有双侧 Best 葡萄膜血管样营养不良和单侧脉络膜新生血管病史。第二只眼有脉络膜血管样条纹合并脉络膜新生血管，曾行热激光光凝治疗。第三只眼有高度近视病史，曾行巩膜扣带术治疗视网膜脱离。第四位患者患有双侧特发性视网膜脉络膜炎。我们从之前的 5 篇文献中确定了 16 例符合 MEWDS 样反应的病例报告。
我们建议，在外周视网膜受损的易感患者中，眼部事件可能引发类似于 MEWDS 的反应。我们假设，外视网膜的损伤可能在引发局部炎症反应中起作用。
