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S. Kiss, I. Kim, S. Pepin, J. Rizzo, III; Localization of Lesions in Multiple Evanescent White Dot Syndrome (MEWDS) Using Optical Coherence Tomography (OCT) . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4502.
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© ARVO (1962-2015); The Authors (2016-present)
MEWDS is a rare disorder of unknown etiology characterized by multiple small (100 to 200 µm), round, slightly indistinct, white to yellow–white, deep, transient, posterior pole retinal lesions. Indocyanine green angiography, electrophysiological recordings, and fluroescein angiography suggest that the lesions in MEWDS occur in the retinal pigment epithelium and photreceptor cells. Using optical coherence tomography (Stratus OCT; Carl Zeiss Meditec AG, Jena Germany), we present the first objective demonstration that the "retinal" lesions of MEWDS are in fact sub–retinal.
Single case report.
A healthy 17–year–old man presented with slightly decreased visual acuity in the right eye and photopsias. Fundoscopy revealed multiple discrete, circumpapillary yellow–white spots in the outer retina with granular perifoveal pigmentary changes. Humphrey and Goldmann perimetry confirmed a unilateral enlarged blind spot. Fluorescein angiography showed early punctate hyperfluorescence of the outer retinal lesions. Extensive laboratory workup was otherwise unremarkable. The patient was diagnosed with MEWDS. OCT demonstrated discrete solid lesions between the retinal pigment epithelium and photoreceptors corresponding to the spots observed clinically. Spontaneous regression of the retinal lesions at six weeks was coincident with visual recovery, a decreased blind spot, and resolution of the lesions seen on OCT.
OCT provides the first objective demonstration of the sub–retinal location of lesions in multiple evanescent white dot syndrome. To our knowledge, this is the first objective demonstration of the exact location of the lesions in MEWDS. OCT may be a valuable adjunct in the diagnosis and monitoring of patients with this disorder.
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