Enríquez-Fuentes Jacobo Emilio, Cuba-Sulluchuco Fiorella Katherine, Donate-López Juan, Fernández-Vigo José Ignacio, Valverde-Megías Alicia
Department of Ophthalmology, Hospital Clínico San Carlos, Madrid, Spain.
Ocul Immunol Inflamm. 2025 Apr;33(3):482-484. doi: 10.1080/09273948.2024.2416524. Epub 2024 Oct 15.
To report a case of possible multiple evanescent white dot syndrome secondary (MEWDS) to acute retinal pigment epitheliitis (ARPE).
Case report.
A 16-year-old female presented to the ophthalmology emergency department with a 5-day history of blurred vision in the left eye (OS). Initial examination revealed a visual acuity (VA) of 89 letters on the Early Treatment Diabetic Retinopathy Study (ETDRS)(-0.08 logMAR) chart in the right eye (OD) and 53 letters(0.64 logMAR) in the OS. Anterior segment biomicroscopy was normal, with no evidence of inflammation in the anterior chamber. Evaluation of the posterior pole revealed an alteration in the retinal pigment epithelium (RPE) in the OS. Optical coherence tomography (OCT) at the macular level showed disruption at the external limiting membrane (ELM), ellipsoid zone (EZ), interdigitation zone (IZ), and the RPE-Bruch's membrane (RPE-Bm) complex. Fundus autofluorescence (FAF) demonstrated hypofluorescent areas in the peripapillary region. No treatment was indicated. After two weeks, there was an improvement in VA, with 90 ETDRS letters(-0.1 logMAR) in the OD and 85 letters(0.0 logMAR) in the OS, as well as improvement in the OCT at the level of the ELM and EZ. However, a marked increase in white spots was observed throughout the posterior pole. By 5-months post-onset, a complete resolution of retinal alterations was observed in both OCT and FAF.
ARPE and MEWDS exhibit overlapping clinical features, which can sometimes complicate differentiation. This case is consistent with MEWDS secondary to ARPE, although an atypical presentation of MEWDS cannot be ruled out.
报告一例可能继发于急性视网膜色素上皮炎（ARPE）的多发性一过性白点综合征（MEWDS）病例。
病例报告。
一名16岁女性因左眼（OS）视力模糊5天就诊于眼科急诊科。初始检查显示右眼（OD）在早期糖尿病视网膜病变研究（ETDRS）视力表上的视力（VA）为89个字母（-0.08 logMAR），左眼为53个字母（0.64 logMAR）。前段生物显微镜检查正常，前房无炎症迹象。后极部评估显示左眼视网膜色素上皮（RPE）有改变。黄斑区光学相干断层扫描（OCT）显示外核层（ELM）、椭圆体带（EZ）、指状交叉带（IZ）以及RPE-布鲁赫膜（RPE-Bm）复合体中断。眼底自发荧光（FAF）显示视乳头周围区域有低荧光区。无需治疗。两周后，视力有所改善，右眼为90个ETDRS字母（-0.1 logMAR），左眼为85个字母（0.0 logMAR），ELM和EZ水平的OCT也有所改善。然而，整个后极部可见白点明显增多。发病后5个月，OCT和FAF显示视网膜改变完全消退。
ARPE和MEWDS表现出重叠的临床特征，有时会使鉴别复杂化。尽管不能排除MEWDS的非典型表现，但该病例符合继发于ARPE的MEWDS。
