Multiple evanescent white dot syndrome (MEWDS): update on practical appraisal, diagnosis and clinicopathology; a review and an alternative comprehensive perspective

Journal of Ophthalmic Inflammation and Infection

Ilknur Tugal-Tutkun¹  Alessandro Mantovani²  Carl P. Herbort³  Ioannis Papasavvas³ 

[1] Department of Ophthalmology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey;Department of Ophthalmology, Valduce Hospital, Como, Italy;Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Clinic Montchoisi Teaching Centre, Rue Charles-Monnard 6, CH-1003, Lausanne, Switzerland;

关键词: MEWDS;    ICGA;    PICCPs;    BL-FAF;   

DOI  :  10.1186/s12348-021-00279-7

来源: Springer

【 摘 要 】

BackgroundMultiple evanescent white dot syndrome (MEWDS) is a rare inflammatory eye condition affecting the outer retina as a consequence of choriocapillaris non perfusion. The pathophysiology of MEWDS will be discussed based clinical appraisal and on multimodal imaging appraisal.MethodsNarrative review and perspective opinion.ResultsLiterature review results helped us to put forward (1) the specific symptomatology (decreased/blurred vision, photopsia, subjective scotomas), (2) the ill-asserted character of clinical findings (foveal granularity, white dots in fundoscopy), (3) and the crucial importance of multimodal imaging with the diagnostic triad of ICGA hypofluorescent areas, BL-FAF hyperautofluorescent areas and loss/damage of IS/OS-ellipsoid zone on SD-OCT that characterise the disease and can practically help the clinician to diagnose MEWDS. A comprehensive alternative perspective of the disease was formulated.ConclusionsThe bulk of evidence that we are presenting in this review, thanks to new performing non-invasive and invasive imaging modalities, is sufficiently compelling to consider MEWDS as a primary choriocapillaritis/inflammatory choriocapillaropathy. Multimodal imaging allows the clinician to diagnose MEWDS with a high level of certainty and ensures a precise follow-up.

【 授权许可】

CC BY