Multimodal Imaging in an Unusual Cluster of Multiple Evanescent White Dot Syndrome
Identifieur interne : 000389 ( Pmc/Checkpoint ); précédent : 000388; suivant : 000390Multimodal Imaging in an Unusual Cluster of Multiple Evanescent White Dot Syndrome
Auteurs : Orly Gal-Or [Israël] ; Ethan Priel [Israël] ; Irit Rosenblatt [Israël] ; Shiri Shulman [Israël] ; Michal Kramer [Israël]Source :
- Journal of Ophthalmology [ 2090-004X ] ; 2017.
Abstract
To describe an unusual cluster of multiple evanescent white dot syndrome (MEWDS) encountered within a 3-month period.
This retrospective observation study is comprised of seven patients who presented with MEWDS in a 3-month period in central Israel. Data were collected from patients' medical records on clinical, multimodal imaging, and viral serology findings.
Six women and one man of mean age 31.5 ± 7.2 years. Three reported a precedent viral infection. All had unilateral decreased vision. Funduscopy revealed foveal granularity.
Hyperfluorescent spots on blue autofluorescence (BAF), hypofluorescent spots on indocyanine green angiography, dark lesions on infrared photos, and ellipsoid zone irregularities on spectral domain optical coherence tomography (SD-OCT). Resolution of the spots on BAF correlated with anatomic (SD-OCT) and visual recovery. OCT angiography performed following the convalescence stage demonstrated intact retinal and choroidal flow. Serologic findings were inconclusive.
We report a unique cluster of MEWDS patients presented in a short period of time. SD-OCT findings of ellipsoid zone disruption in combination with other multimodal imaging modalities are outlined meticulously. Recognizing these imaging features along with high index of clinical suspicion is important for the diagnosis of MEWDS. Serologic testing might be considered in future patients.
Url:
DOI: 10.1155/2017/7535320
PubMed: 28584665
PubMed Central: 5444036
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Multimodal Imaging in an Unusual Cluster of Multiple Evanescent White Dot Syndrome</title><author><name sortKey="Gal Or, Orly" sort="Gal Or, Orly" uniqKey="Gal Or O" first="Orly" last="Gal-Or">Orly Gal-Or</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva</wicri:regionArea><wicri:noRegion>4941492 Petach Tikva</wicri:noRegion></affiliation></author><author><name sortKey="Priel, Ethan" sort="Priel, Ethan" uniqKey="Priel E" first="Ethan" last="Priel">Ethan Priel</name><affiliation wicri:level="1"><nlm:aff id="I2">MOR Institute for Medical Data, 5126413 Bnei Brak, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>MOR Institute for Medical Data, 5126413 Bnei Brak</wicri:regionArea><wicri:noRegion>5126413 Bnei Brak</wicri:noRegion></affiliation></author><author><name sortKey="Rosenblatt, Irit" sort="Rosenblatt, Irit" uniqKey="Rosenblatt I" first="Irit" last="Rosenblatt">Irit Rosenblatt</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva</wicri:regionArea><wicri:noRegion>4941492 Petach Tikva</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">MOR Institute for Medical Data, 5126413 Bnei Brak, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>MOR Institute for Medical Data, 5126413 Bnei Brak</wicri:regionArea><wicri:noRegion>5126413 Bnei Brak</wicri:noRegion></affiliation></author><author><name sortKey="Shulman, Shiri" sort="Shulman, Shiri" uniqKey="Shulman S" first="Shiri" last="Shulman">Shiri Shulman</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 62431 Tel Aviv, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 62431 Tel Aviv</wicri:regionArea><wicri:noRegion>62431 Tel Aviv</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv</wicri:regionArea><wicri:noRegion>6997801 Tel Aviv</wicri:noRegion></affiliation></author><author><name sortKey="Kramer, Michal" sort="Kramer, Michal" uniqKey="Kramer M" first="Michal" last="Kramer">Michal Kramer</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Ophthalmology, Rabin 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Gal-Or</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva</wicri:regionArea><wicri:noRegion>4941492 Petach Tikva</wicri:noRegion></affiliation></author><author><name sortKey="Priel, Ethan" sort="Priel, Ethan" uniqKey="Priel E" first="Ethan" last="Priel">Ethan Priel</name><affiliation wicri:level="1"><nlm:aff id="I2">MOR Institute for Medical Data, 5126413 Bnei Brak, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>MOR Institute for Medical Data, 5126413 Bnei Brak</wicri:regionArea><wicri:noRegion>5126413 Bnei Brak</wicri:noRegion></affiliation></author><author><name sortKey="Rosenblatt, Irit" sort="Rosenblatt, Irit" uniqKey="Rosenblatt I" first="Irit" last="Rosenblatt">Irit Rosenblatt</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva</wicri:regionArea><wicri:noRegion>4941492 Petach Tikva</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">MOR Institute for Medical Data, 5126413 Bnei Brak, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>MOR Institute for Medical Data, 5126413 Bnei Brak</wicri:regionArea><wicri:noRegion>5126413 Bnei Brak</wicri:noRegion></affiliation></author><author><name sortKey="Shulman, Shiri" sort="Shulman, Shiri" uniqKey="Shulman S" first="Shiri" last="Shulman">Shiri Shulman</name><affiliation wicri:level="1"><nlm:aff id="I3">Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 62431 Tel Aviv, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 62431 Tel Aviv</wicri:regionArea><wicri:noRegion>62431 Tel Aviv</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv</wicri:regionArea><wicri:noRegion>6997801 Tel Aviv</wicri:noRegion></affiliation></author><author><name sortKey="Kramer, Michal" sort="Kramer, Michal" uniqKey="Kramer M" first="Michal" last="Kramer">Michal Kramer</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva</wicri:regionArea><wicri:noRegion>4941492 Petach Tikva</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I2">MOR Institute for Medical Data, 5126413 Bnei Brak, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>MOR Institute for Medical Data, 5126413 Bnei Brak</wicri:regionArea><wicri:noRegion>5126413 Bnei Brak</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="I4">Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel</nlm:aff><country xml:lang="fr">Israël</country><wicri:regionArea>Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv</wicri:regionArea><wicri:noRegion>6997801 Tel Aviv</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Ophthalmology</title><idno type="ISSN">2090-004X</idno><idno type="eISSN">2090-0058</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objective</title><p> To describe an unusual cluster of multiple evanescent white dot syndrome (MEWDS) encountered within a 3-month period. </p></sec><sec><title>Methods</title><p> This retrospective observation study is comprised of seven patients who presented with MEWDS in a 3-month period in central Israel. Data were collected from patients' medical records on clinical, multimodal imaging, and viral serology findings. </p></sec><sec><title>Results</title><p> Six women and one man of mean age 31.5 ± 7.2 years. Three reported a precedent viral infection. All had unilateral decreased vision. Funduscopy revealed foveal granularity. </p></sec><sec><title>Main Imaging Findings</title><p> Hyperfluorescent spots on blue autofluorescence (BAF), hypofluorescent spots on indocyanine green angiography, dark lesions on infrared photos, and ellipsoid zone irregularities on spectral domain optical coherence tomography (SD-OCT). Resolution of the spots on BAF correlated with anatomic (SD-OCT) and visual recovery. OCT angiography performed following the convalescence stage demonstrated intact retinal and choroidal flow. Serologic findings were inconclusive. </p></sec><sec><title>Conclusion</title><p> We report a unique cluster of MEWDS patients presented in a short period of time. SD-OCT findings of ellipsoid zone disruption in combination with other multimodal imaging modalities are outlined meticulously. Recognizing these imaging features along with high index of clinical suspicion is important for the diagnosis of MEWDS. Serologic testing might be considered in future patients.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Polk, T D" uniqKey="Polk T">T. D. Polk</name></author><author><name sortKey="Goldman, E J" uniqKey="Goldman E">E. J. Goldman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jampol, L M" uniqKey="Jampol L">L. M. Jampol</name></author><author><name sortKey="Sieving, P A" uniqKey="Sieving P">P. A. Sieving</name></author><author><name sortKey="Pugh, D" uniqKey="Pugh D">D. Pugh</name></author><author><name sortKey="Fishman, G A" uniqKey="Fishman G">G. A. Fishman</name></author><author><name sortKey="Gilbert, H" uniqKey="Gilbert H">H. Gilbert</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tsai, L" uniqKey="Tsai L">L. Tsai</name></author><author><name sortKey="Jampol, L M" uniqKey="Jampol L">L. M. Jampol</name></author><author><name sortKey="Pollock, S C" uniqKey="Pollock S">S. C. Pollock</name></author><author><name sortKey="Olk, J" uniqKey="Olk J">J. Olk</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shelsta, H N" uniqKey="Shelsta H">H. N. Shelsta</name></author><author><name sortKey="Rao, R R" uniqKey="Rao R">R. R. Rao</name></author><author><name sortKey="Bhatt, H K" uniqKey="Bhatt H">H. K. Bhatt</name></author><author><name sortKey="Jampol, L M" uniqKey="Jampol L">L. M. Jampol</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chung, Y M" uniqKey="Chung Y">Y. M. Chung</name></author><author><name sortKey="Yeh, T S" uniqKey="Yeh T">T. S. Yeh</name></author><author><name sortKey="Liu, J H" uniqKey="Liu J">J. H. Liu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Sieving, P A" uniqKey="Sieving P">P. A. Sieving</name></author><author><name sortKey="Fishman, G A" uniqKey="Fishman G">G. A. Fishman</name></author><author><name sortKey="Jampol, L M" uniqKey="Jampol L">L. M. Jampol</name></author><author><name sortKey="Pugh, D" uniqKey="Pugh D">D. Pugh</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gross, N E" uniqKey="Gross N">N. E. Gross</name></author><author><name sortKey="Yannuzzi, L A" uniqKey="Yannuzzi L">L. A. Yannuzzi</name></author><author><name sortKey="Freund, K B" uniqKey="Freund K">K. B. Freund</name></author><author><name sortKey="Spaide, R F" uniqKey="Spaide R">R. F. Spaide</name></author><author><name sortKey="Amato, G P" uniqKey="Amato G">G. P. Amato</name></author><author><name sortKey="Sigal, R" uniqKey="Sigal R">R. Sigal</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nguyen, M H T" uniqKey="Nguyen M">M. H. T. Nguyen</name></author><author><name sortKey="Witkin, A J" uniqKey="Witkin A">A. J. Witkin</name></author><author><name sortKey="Reichel, E" uniqKey="Reichel E">E. Reichel</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ryan, P T" uniqKey="Ryan P">P. T. Ryan</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Abu Yaghi, N E" uniqKey="Abu Yaghi N">N. E. Abu-Yaghi</name></author><author><name sortKey="Hartono, S P" uniqKey="Hartono S">S. P. Hartono</name></author><author><name sortKey="Hodge, D O" uniqKey="Hodge D">D. O. Hodge</name></author><author><name sortKey="Pulido, J S" uniqKey="Pulido J">J. S. Pulido</name></author><author><name sortKey="Bakri, S J" uniqKey="Bakri S">S. J. Bakri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Aoyagi, R" uniqKey="Aoyagi R">R. Aoyagi</name></author><author><name sortKey="Hayashi, T" uniqKey="Hayashi T">T. Hayashi</name></author><author><name sortKey="Masai, A" uniqKey="Masai A">A. Masai</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Silva, R A" uniqKey="Silva R">R. A. Silva</name></author><author><name sortKey="Albini, T A" uniqKey="Albini T">T. A. Albini</name></author><author><name sortKey="Flynn, H W" uniqKey="Flynn H">H. W. Flynn</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hashimoto, Y" uniqKey="Hashimoto Y">Y. Hashimoto</name></author><author><name sortKey="Saito, W" uniqKey="Saito W">W. Saito</name></author><author><name sortKey="Saito, M" uniqKey="Saito M">M. Saito</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Marsiglia, M" uniqKey="Marsiglia M">M. Marsiglia</name></author><author><name sortKey="Gallego Pinazo, R" uniqKey="Gallego Pinazo R">R. Gallego-Pinazo</name></author><author><name sortKey="Cuhna De Souza, E" uniqKey="Cuhna De Souza E">E. Cuhna de Souza</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Jia, Y" uniqKey="Jia Y">Y. Jia</name></author><author><name sortKey="Wei, E" uniqKey="Wei E">E. Wei</name></author><author><name sortKey="Wang, X" uniqKey="Wang X">X. Wang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Spaide, R F" uniqKey="Spaide R">R. F. Spaide</name></author><author><name sortKey="Curcio, C A" uniqKey="Curcio C">C. A. Curcio</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baglivo, E" uniqKey="Baglivo E">E. Baglivo</name></author><author><name sortKey="Safran, A B" uniqKey="Safran A">A. B. Safran</name></author><author><name sortKey="Borruat, F X" uniqKey="Borruat F">F. X. Borruat</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stangos, A" uniqKey="Stangos A">A. Stangos</name></author><author><name sortKey="Zaninetti, M" uniqKey="Zaninetti M">M. Zaninetti</name></author><author><name sortKey="Petropoulos, I" uniqKey="Petropoulos I">I. Petropoulos</name></author><author><name sortKey="Baglivo, E" uniqKey="Baglivo E">E. Baglivo</name></author><author><name sortKey="Pournaras, C" uniqKey="Pournaras C">C. Pournaras</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Ogino, K" uniqKey="Ogino K">K. Ogino</name></author><author><name sortKey="Kishi, S" uniqKey="Kishi S">S. Kishi</name></author><author><name sortKey="Yoshimura, N" uniqKey="Yoshimura N">N. Yoshimura</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="De Bats, F" uniqKey="De Bats F">F. De Bats</name></author><author><name sortKey="Wolff, B" uniqKey="Wolff B">B. Wolff</name></author><author><name sortKey="Vasseur, V" uniqKey="Vasseur V">V. Vasseur</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hua, R" uniqKey="Hua R">R. Hua</name></author><author><name sortKey="Chen, K" uniqKey="Chen K">K. Chen</name></author><author><name sortKey="Liu, L M" uniqKey="Liu L">L.-M. Liu</name></author><author><name sortKey="Liu, N N" uniqKey="Liu N">N.-N. Liu</name></author><author><name sortKey="Chen, L" uniqKey="Chen L">L. Chen</name></author><author><name sortKey="Teng, W P" uniqKey="Teng W">W.-P. Teng</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Boretsky, A" uniqKey="Boretsky A">A. Boretsky</name></author><author><name sortKey="Mirza, S" uniqKey="Mirza S">S. Mirza</name></author><author><name sortKey="Khan, F" uniqKey="Khan F">F. Khan</name></author><author><name sortKey="Motamedi, M" uniqKey="Motamedi M">M. Motamedi</name></author><author><name sortKey="Van Kuijk, F J" uniqKey="Van Kuijk F">F. J. van Kuijk</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Ophthalmol</journal-id><journal-id journal-id-type="iso-abbrev">J Ophthalmol</journal-id><journal-id journal-id-type="publisher-id">JOPH</journal-id><journal-title-group><journal-title>Journal of Ophthalmology</journal-title></journal-title-group><issn pub-type="ppub">2090-004X</issn><issn pub-type="epub">2090-0058</issn><publisher><publisher-name>Hindawi</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">28584665</article-id><article-id pub-id-type="pmc">5444036</article-id><article-id pub-id-type="doi">10.1155/2017/7535320</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Multimodal Imaging in an Unusual Cluster of Multiple Evanescent White Dot Syndrome</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-3421-4555</contrib-id><name><surname>Gal-Or</surname><given-names>Orly</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Priel</surname><given-names>Ethan</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Rosenblatt</surname><given-names>Irit</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Shulman</surname><given-names>Shiri</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref><xref ref-type="aff" rid="I4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kramer</surname><given-names>Michal</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="aff" rid="I2"><sup>2</sup></xref><xref ref-type="aff" rid="I4"><sup>4</sup></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Department of Ophthalmology, Rabin Medical Center-Beilinson Hospital, 4941492 Petach Tikva, Israel</aff><aff id="I2"><sup>2</sup>MOR Institute for Medical Data, 5126413 Bnei Brak, Israel</aff><aff id="I3"><sup>3</sup>Department of Ophthalmology, Tel Aviv Sourasky Medical Center, 62431 Tel Aviv, Israel</aff><aff id="I4"><sup>4</sup>Sackler School of Medicine, Tel Aviv University, 6997801 Tel Aviv, Israel</aff><author-notes><corresp id="cor1">*Orly Gal-Or: <email>wataya@gmail.com</email></corresp><fn fn-type="other"><p>Academic Editor: Maria-Andreea Gamulescu</p></fn></author-notes><pub-date pub-type="ppub"><year>2017</year></pub-date><pub-date pub-type="epub"><day>11</day><month>5</month><year>2017</year></pub-date><volume>2017</volume><elocation-id>7535320</elocation-id><history><date date-type="received"><day>11</day><month>12</month><year>2016</year></date><date date-type="accepted"><day>14</day><month>3</month><year>2017</year></date></history><permissions><copyright-statement>Copyright © 2017 Orly Gal-Or et al.</copyright-statement><copyright-year>2017</copyright-year><license xlink:href="http://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Objective</title><p> To describe an unusual cluster of multiple evanescent white dot syndrome (MEWDS) encountered within a 3-month period. </p></sec><sec><title>Methods</title><p> This retrospective observation study is comprised of seven patients who presented with MEWDS in a 3-month period in central Israel. Data were collected from patients' medical records on clinical, multimodal imaging, and viral serology findings. </p></sec><sec><title>Results</title><p> Six women and one man of mean age 31.5 ± 7.2 years. Three reported a precedent viral infection. All had unilateral decreased vision. Funduscopy revealed foveal granularity. </p></sec><sec><title>Main Imaging Findings</title><p> Hyperfluorescent spots on blue autofluorescence (BAF), hypofluorescent spots on indocyanine green angiography, dark lesions on infrared photos, and ellipsoid zone irregularities on spectral domain optical coherence tomography (SD-OCT). Resolution of the spots on BAF correlated with anatomic (SD-OCT) and visual recovery. OCT angiography performed following the convalescence stage demonstrated intact retinal and choroidal flow. Serologic findings were inconclusive. </p></sec><sec><title>Conclusion</title><p> We report a unique cluster of MEWDS patients presented in a short period of time. SD-OCT findings of ellipsoid zone disruption in combination with other multimodal imaging modalities are outlined meticulously. Recognizing these imaging features along with high index of clinical suspicion is important for the diagnosis of MEWDS. Serologic testing might be considered in future patients.</p></sec></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>22-year-old female with visual acuity of 6/20 in her left eye (a). Color photograph of the left eye showing foveal granularity (b). FA of the left eye shows mild optic disc leakage at late phase (4 min 56 seconds) (c). SD-OCT shows disrupted ellipsoid zone more pronounced at the fovea.</p></caption><graphic xlink:href="JOPH2017-7535320.001"></graphic></fig><fig id="fig2" orientation="portrait" position="float"><label>Figure 2</label><caption><p>Color photograph of the left eye of patient 1 showing foveal granularity and lack of white dots (obtained 2 days after initial symptoms). Color photograph of the right eye of patient 2 showing foveal granularity with faint white retinal lesions temporal to the macula (arrowhead) (obtained 1 week after initial symptoms). Color photograph of the right eye of patient 7, demonstrating foveal granularity and scattered temporal yellow-white deep retinal lesions (arrowheads) (obtained 12 days after initial symptoms).</p></caption><graphic xlink:href="JOPH2017-7535320.002"></graphic></fig><fig id="fig3" orientation="portrait" position="float"><label>Figure 3</label><caption><p>Corresponding images of patient 6: (a) BAF showing hyperautofluoresent lesions and (b) ICGA demonstrating hypofluorescent spots in similar locations, taken 1 week after initial symptom. Areas of disruption of ellipsoid zone demonstrated on SD-OCT (arrows) (d), corresponding to the dark lesions seen on IR (arrows) (c) of the same patient.</p></caption><graphic xlink:href="JOPH2017-7535320.003"></graphic></fig><fig id="fig4" orientation="portrait" position="float"><label>Figure 4</label><caption><p>SD-OCT of 3 eyes of 3 patients, demonstrating disruption of the ellipsoid zone in the subfoveal area (arrowheads). Note the foveal hyperreflectivity extending into the inner retinal layers. Patient 1 (2 days after initial symptom). Patient 4 (1 week after initial symptom). Patient 7 (2 weeks after initial symptoms).</p></caption><graphic xlink:href="JOPH2017-7535320.004"></graphic></fig><fig id="fig5" orientation="portrait" position="float"><label>Figure 5</label><caption><p>Consecutive images of patient 7. Initial visit, VA 6/18 (a, b) and at 6-month follow-up, VA 6/6.6 (c, d). BAF imaging demonstrating resolution of hyperautofluorescent spots. SD-OCT demonstrating the disruption of ellipsoid zone in the subfoveal area and restoration of the ellipsoid zone at the final visit.</p></caption><graphic xlink:href="JOPH2017-7535320.005"></graphic></fig><fig id="fig6" orientation="portrait" position="float"><label>Figure 6</label><caption><p>OCTA images following convalescence stage of patients 7's right eye (a-b) and 6's left eye (c-d). The green and red lines represent the <italic>x</italic> and <italic>y</italic> axes. Patient 7 after recurrent episodes. 3 × 3 mm OCT angiogram of the choriocapillaris (a1), superficial layer (a2), and deep layer (a3) centered at the macula without any flow compromise. Corresponding <italic>x</italic>-axis OCT structural B-scan (b1) simultaneously obtained during the same scan as the OCT angiogram with flow overlay at the cross-section demonstrated by the green line in (a1). SD-OCT (b2) demonstrating normal anatomy of the outer retina 6 months after the first acute episode. Patient 6, 3× 3 mm OCT angiogram of the choriocapillaris (c1), superficial layer (c2), and deep layer (c3) centered at the macula without any flow compromise. 3 × 3 mm en face structural OCT (d1) of the choriocapillaris centered at the macula as in c1. This image was simultaneously obtained during the same scan as the OCT angiogram in (c). En face structural OCT of the deep (d2) and outer retina (d3).</p></caption><graphic xlink:href="JOPH2017-7535320.006"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>Demographic and clinical data.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Patient number</th><th align="center" rowspan="1" colspan="1">Sex</th><th align="center" rowspan="1" colspan="1">Age (yr)</th><th align="center" rowspan="1" colspan="1">Viral prodrome</th><th align="center" rowspan="1" colspan="1">Time of presentation</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">30</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">July 2013</td></tr><tr><td align="left" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">M</td><td align="center" rowspan="1" colspan="1">32</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">July 2013</td></tr><tr><td align="left" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">39</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">July 2013</td></tr><tr><td align="left" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">34</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">July 2013</td></tr><tr><td align="left" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">22</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">July 2013</td></tr><tr><td align="left" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">41</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">August 2013</td></tr><tr><td align="left" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">F</td><td align="center" rowspan="1" colspan="1">23</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">September 2013</td></tr></tbody></table><table-wrap-foot><fn><p>+: present; −: absent.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Clinical and multimodal imaging findings.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="2" colspan="1">Pt. number</th><th align="center" rowspan="2" colspan="1">VA at <break></break>presentation</th><th align="center" rowspan="2" colspan="1">VA at last <break></break>follow-up</th><th align="center" colspan="3" rowspan="1">Clinical examination</th><th align="center" rowspan="2" colspan="1">BAF lesions</th><th align="center" rowspan="2" colspan="1">IR lesions</th><th align="center" rowspan="2" colspan="1">SD-OCT EZ <break></break>disruption</th><th align="center" colspan="2" rowspan="1">FA</th><th align="center" rowspan="2" colspan="1">ICG</th><th align="center" rowspan="1" colspan="1">OCTA</th></tr><tr><th align="center" rowspan="1" colspan="1">Foveal <break></break>granularity</th><th align="center" rowspan="1" colspan="1">Swollen disc</th><th align="center" rowspan="1" colspan="1">Spots/dots</th><th align="center" rowspan="1" colspan="1">Optic disc <break></break>leakage</th><th align="center" rowspan="1" colspan="1">Spots</th><th align="center" rowspan="1" colspan="1">Flow compromise of <break></break>choriocapillaris and <break></break>retinal vasculture</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">6/12</td><td align="center" rowspan="1" colspan="1">6/6</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">2<sup>∗</sup></td><td align="center" rowspan="1" colspan="1">6/18</td><td align="center" rowspan="1" colspan="1">6/6.6</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">6/9</td><td align="center" rowspan="1" colspan="1">6/6</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">4<sup>∗</sup></td><td align="center" rowspan="1" colspan="1">6/30</td><td align="center" rowspan="1" colspan="1">6/6</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">−</td><td rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">6/20</td><td align="center" rowspan="1" colspan="1">6/6.6</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td rowspan="1" colspan="1"></td><td rowspan="1" colspan="1"></td></tr><tr><td align="left" rowspan="1" colspan="1">6<sup>∗∗</sup></td><td align="center" rowspan="1" colspan="1">6/10</td><td align="center" rowspan="1" colspan="1">6/6.6</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td></tr><tr><td align="left" rowspan="1" colspan="1">7<sup>∗∗</sup></td><td align="center" rowspan="1" colspan="1">6/18</td><td align="center" rowspan="1" colspan="1">6/6.6</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">+</td><td align="center" rowspan="1" colspan="1">−</td><td align="center" rowspan="1" colspan="1">+</td><td rowspan="1" colspan="1"></td><td align="center" rowspan="1" colspan="1">−</td></tr></tbody></table><table-wrap-foot><fn><p><sup>∗</sup>In patients 2 and 4, BAF was not done; <sup>∗∗</sup>OCTA was performed following convalescence stage; VA: visual acuity of affected eye; BAF: blue autofluorescence; IR: infrared; FA: fluorescein angiography; SD-OCT: spectral domain optical coherence tomography; ICG: indocyanine green; OCTA: optical coherence tomography angiography; EZ: ellipsoid zone.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Israël</li></country></list><tree><country name="Israël"><noRegion><name sortKey="Gal Or, Orly" sort="Gal Or, Orly" uniqKey="Gal Or O" first="Orly" last="Gal-Or">Orly Gal-Or</name></noRegion><name sortKey="Kramer, Michal" sort="Kramer, Michal" uniqKey="Kramer M" first="Michal" last="Kramer">Michal Kramer</name><name sortKey="Kramer, Michal" sort="Kramer, Michal" uniqKey="Kramer M" first="Michal" last="Kramer">Michal Kramer</name><name sortKey="Kramer, Michal" sort="Kramer, Michal" uniqKey="Kramer M" first="Michal" last="Kramer">Michal Kramer</name><name sortKey="Priel, Ethan" sort="Priel, Ethan" uniqKey="Priel E" first="Ethan" last="Priel">Ethan Priel</name><name sortKey="Rosenblatt, Irit" sort="Rosenblatt, Irit" uniqKey="Rosenblatt I" first="Irit" last="Rosenblatt">Irit Rosenblatt</name><name sortKey="Rosenblatt, Irit" sort="Rosenblatt, Irit" uniqKey="Rosenblatt I" first="Irit" last="Rosenblatt">Irit Rosenblatt</name><name sortKey="Shulman, Shiri" sort="Shulman, Shiri" uniqKey="Shulman S" first="Shiri" last="Shulman">Shiri Shulman</name><name sortKey="Shulman, Shiri" 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