Restored photoreceptor outer segment damage in multiple evanescent white dot syndrome

Area of Science:

• Ophthalmology
• Neuroscience
• Medical Imaging

Background:

• Multiple evanescent white dot syndrome (MEWDS) is an inflammatory condition affecting the retina.
• Understanding the precise impact of MEWDS on retinal structure and function is crucial for diagnosis and management.

Observation:

• This study prospectively investigated seven patients with unilateral MEWDS.
• Optical coherence tomography (OCT), multifocal electroretinography (mfERG), and visual field testing were employed to assess retinal tomography and function.

Findings:

• MEWDS caused disrupted photoreceptor inner/outer segment (IS/OS) junctions, visible on OCT, and impaired visual fields.
• While visual acuity and fundus lesions resolved, residual visual field defects and IS/OS junction irregularities were noted in some cases.
• Electroretinography (ERG) showed marked recovery of responses in affected eyes, indicating functional improvement.

Implications:

• The findings suggest that MEWDS lesions primarily affect photoreceptor outer segments.
• Both morphological and functional recovery of the retina are possible following MEWDS.
• Bilateral photoreceptor dysfunction can occur in MEWDS, even when symptoms are unilateral, highlighting the importance of comprehensive bilateral testing.