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Author Spotlight: Ex Vivo OCT-Based Multimodal Imaging of Human Donor Eyes for Research into Age-Related Macular Degeneration
Published on: May 26, 2023
Multimodal imaging findings in 'hyper-early' stage MEWDS
Armelle Cahuzac1, Benjamin Wolff1, Thibaud Mathis2
1Fondation Ophtalmologique Adolphe de Rothschild (FOR), 25 rue Manin, Paris Cedex 19, Île-de-France, France.
Objective:
To describe a new stage of multiple evanescent white dot syndrome (MEWDS), occurring at a very early phase of the disease.
Methods:
Retrospective analysis of clinical, angiographic and tomographic findings in four patients with 'hyper-early' stage MEWDS.
Results:
In four patients seen within 1 week of the onset of symptoms, fundus analysis revealed macular granity and the classic yellow-white dots, some having no corresponding hyperautofluorescent pattern. Spectral-domain optical coherence tomography (SD-OCT) showed central foveal disruption of the ellipsoid zone (EZ) and interdigitation layer with a hyper-reflective dome-shaped lesion. In two patients, fluorescein angiography (FA) revealed an intermediate hypofluorescent perimacular halo, whereas late indocyanine green angiography (ICGA) showed a hyperfluorescent halo as well as the classic MEWDS features. After a few days, the EZ disruption appeared complete on OCT and fundus autofluorescence (FAF) in all patients. Visual acuity, OCT and FAF findings had fully recovered within 3 months.
Conclusions:
We have shown a new feature of MEWDS on FAF, OCT, FA and ICGA, corresponding to a very early stage of the disease.
Insights
Researchers identified a new, very early stage of Multiple Evanescent White Dot Syndrome (MEWDS). This hyper-early phase shows distinct findings on optical coherence tomography (OCT) and angiography before classic signs appear.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Multiple Evanescent White Dot Syndrome (MEWDS) is an inflammatory condition affecting the retina.
- Understanding the earliest disease manifestations is crucial for timely diagnosis and management.
Purpose of the Study:
- To characterize a previously undescribed, hyper-early stage of MEWDS.
- To delineate the clinical, angiographic, and tomographic features of this early phase.
Main Methods:
- Retrospective analysis of four patients presenting within one week of symptom onset.
- Utilized fundus examination, Spectral-domain Optical Coherence Tomography (SD-OCT), Fluorescein Angiography (FA), and Indocyanine Green Angiography (ICGA).
Main Results:
- Identified macular granularity and yellow-white dots, with some lacking hyperautofluorescence.
- SD-OCT revealed foveal ellipsoid zone (EZ) disruption and a hyper-reflective dome-shaped lesion.
- Angiography showed perimacular halos (hypofluorescent on FA, hyperfluorescent on ICGA) alongside classic MEWDS features.
- EZ disruption progressed, with full recovery of visual acuity and imaging findings within 3 months.
Conclusions:
- A distinct hyper-early stage of MEWDS has been identified.
- This stage presents unique findings on SD-OCT, FA, ICGA, and fundus autofluorescence (FAF).
- Early detection of these features can aid in the diagnosis of MEWDS.
