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S. Kellner, S. Weinitz, U. Kellner; The RPE in Multiple Evanescent White Dot Syndrome Examined With Fundus Autofluorescence, Near-Infrared Autofluorescence and Spectral Domain OCT. Invest. Ophthalmol. Vis. Sci. 2010;51(13):325.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the RPE in the active stage and the recovery stage of multiple evanescent white dot syndrome (MEWDS) using different retinal imaging methods.
Two patients with MEWDS underwent retinal imaging using fundus autofluoresence (FAF; excitation 480 nm, barrier filter 500 nm) and near-infrared autofluorescence (NIA; excitation 787 nm, barrier filter 800 nm) using a confocal scanning laser ophthalmoscope (HRA2, Heidelberg Engineering, Heidelberg, Germany) as well as spectral domain OCT (sdOCT; Spectralis OCT, Heidelberg Engineering, Heidelberg, Germany).
In the acute stage of MEWDS, granular foveal changes correspond to markedly reduced NIA intensity and an interruption of the photoreceptor inner/outer segment layer in the sdOCT, whereas FAF alterations where limited. In contrast, the white flecks in the macula and mid-periphery can be better identified with FAF compared to NIA. FAF identifies several more flecks than are ophthalmoscopically visible. These flecks correspond to a small interruption in the photoreceptor inner/outer segment layer. During follow-up, foveal and peripheral structural integrity is reconstituted over a period of several months.
MEWDS affects the RPE and the photoreceptor inner/outer segment layer in the acute stage with reconstitution of the structural damage during the recovery phase. The resolution of FAF and NIA alterations indicates, that there is a limited change of RPE cell function, but no permanent damage to the RPE.
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