Finn Avni P, Khurana Rahul N
Northern California Retina Vitreous Associates, Mountain View, CA, USA.
Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.
Am J Ophthalmol Case Rep. 2020 Dec 19;21:101004. doi: 10.1016/j.ajoc.2020.101004. eCollection 2021 Mar.
We report a patient with unilateral symptoms presenting with bilateral multiple evanescent white dot syndrome (MEWDS) in order to highlight the utility of multimodal imaging in revealing asymptomatic lesions in the fellow eye and underscore the importance of looking for silent bilateral disease.
A 39-year-old man presented with blurry vision and photopsias in the left eye (OS). Funduscopic examination revealed characteristic granular white dots in the posterior pole OS. Multimodal imaging included fundus autofluorescence, which revealed numerous hyperautofluorescent lesions in both eyes, more than appreciated on clinical examination alone and corresponding ellipsoid disruption on OCT. Seven bilateral cases have been previously reported, all of which are asymmetric, similar to the case reported and are summarized here.
While MEWDS is most often thought of as a unilateral disease, it may rarely present bilaterally as in the case presented here. Multimodal imaging is especially useful in diagnosis and follow-up. Fundus autofluorescence may be the most sensitive and practical test for detecting MEWDS, revealing lesions in the absence of white dots on clinical exam.
我们报告一例表现为单侧症状的双侧多发性一过性白点综合征（MEWDS）患者，以强调多模态成像在发现对侧眼无症状病变方面的作用，并强调寻找隐匿性双侧疾病的重要性。
一名39岁男性因左眼视力模糊和闪光感就诊。眼底检查发现左眼后极部有特征性的颗粒状白点。多模态成像包括眼底自发荧光，显示双眼有大量高自发荧光病变，比仅通过临床检查发现的更多，且光学相干断层扫描（OCT）显示相应的椭圆体破坏。此前已报道过7例双侧病例，均不对称，与本病例相似，在此进行总结。
虽然MEWDS通常被认为是一种单侧疾病，但如本病例所示，它很少会双侧发病。多模态成像在诊断和随访中特别有用。眼底自发荧光可能是检测MEWDS最敏感和实用的检查方法，可在临床检查未发现白点的情况下发现病变。
