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Expanding the Clinical Spectrum of Multiple Evanescent White Dot Syndrome with Overlapping Multifocal Choroiditis

Hyun Goo Kang1,2, Tae Young Kim1, Min Kim1,2

  • 1Department of Ophthalmology, Institute of Vision Research, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Ocular Immunology and Inflammation
|September 2, 2020
PubMed
Abstract

Insights

Multifocal evanescent white dot syndrome (MEWDS) can overlap with multifocal choroiditis (MFC). Overlapping cases show increased choroidal thickness that resolves, but subfoveal MFC indicates a poor visual prognosis.

Area of Science:

  • Ophthalmology
  • Retinal Diseases
  • Inflammatory Eye Conditions

Background:

  • Multifocal evanescent white dot syndrome (MEWDS) is an inflammatory condition affecting the retina.
  • Distinguishing MEWDS from other white dot syndromes is crucial for appropriate management.

Purpose of the Study:

  • To investigate the occurrence and characteristics of multifocal choroiditis (MFC) in patients with MEWDS.
  • To compare ocular findings in MEWDS patients with and without overlapping MFC.

Main Methods:

  • Retrospective review of 34 patients diagnosed with MEWDS between 2008 and 2018.
  • Analysis of multimodal imaging, including optical coherence tomography angiography (OCTA).

Main Results:

  • Five patients developed MFC lesions in affected eyes; one developed MFC in the fellow eye.
  • Eyes with MFC exhibited significantly thicker choroids at presentation (316.5 µm vs 197.3 µm, P=.001).
  • Subfoveal MFC was associated with a poor visual prognosis (P=.019); OCTA revealed suspected choriocapillaris flow deficits.

Conclusions:

  • MEWDS can present with overlapping MFC in the same or fellow eyes.
  • Increased choroidal thickness in MEWDS patients may indicate MFC and resolves with treatment.
  • Early identification of MFC in MEWDS is vital for predicting visual outcomes.
Keywords:
Choriocapillarismultifocal choroiditismultiple evanescent white dot syndromeoptical coherence tomography angiographywhite dot syndrome

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