Multiple evanescent white dot syndrome and multiple evanescent white dot syndrome-like change_Chinese Journal of Ocular Fundus Diseases

Authors：

Liu Xing , Cui Kunming , Tian Yuzhi ,  Yu Suqin

Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shang hai Clinical Research Center for Eye Diseases, Shanghai 200080, China;
Liu Xing is working on the Department of Ophthalmology, Quanzhou Children’s Hospital, Quanzhou 362000, China; Cui Kunming is working on the Department of Ophthalmology, The General Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, China; Tian Yuzhi is working on the Department of Ophthalmology, Dali Aier Eye Hospital, Dali 671000, China;

Corresponding author：

Yu Suqin, Email: sq-yu@163.com

Keywords：

Multiple evanescent white dot syndrome; Multiple evanescent white dot syndrome-like change; Multimode image; Review

DOI：

10.3760/cma.j.cn511434-20211228-00726

Video：

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Multiple evanescent white dot syndrome (MEWDS) is an acute retinal disease characterized by multifocal white spots in the fundus often seen in the unilateral eye. The lesions mainly involve the retinal pigment epithelium and the outer retinal structure. Typical ocular manifestations of MEWDS include grayish-white outer retinal spots with a clear borderline identified on the fundus, findings of hyper-autofluorescence in the early stage consistent with the spots identified on the fundus, and the optical coherence tomography manifestation of multifocal disruption of the ellipsoid zone. With the rapid development of multimodal imaging technology, some scholars found that these manifestations are not exclusive to MEWDS as some types of chorioretinopathy can also show MEWDS-like changes. The etiology of these diseases may be inflammation, infection, immunity, or tumor-related, misdiagnosed by masquerading as MEWDS. Here we summarized the clinical manifestations and imaging features of MEWDS and reviewed the fundus lesions changes that can be misdiagnosed as MEWDS.

Citation： Liu Xing, Cui Kunming, Tian Yuzhi, Yu Suqin. Multiple evanescent white dot syndrome and multiple evanescent white dot syndrome-like change. Chinese Journal of Ocular Fundus Diseases, 2023, 39(5): 430-436. doi: 10.3760/cma.j.cn511434-20211228-00726 Copy

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1. Jampol LM, Sieving PA, Pugh D, et al. Multiple evanescent white dot syndrome. Ⅰ. Clinical findings[J]. Arch Ophthalmol, 1984, 102(5): 671-674. DOI: 10.1001/archopht.1984.01040030527008.
2. Polk TD, Goldman EJ. White-dot chorioretinal inflammatory syndromes[J]. Int Ophthalmol Clin, 1999, 39(4): 33-53. DOI: 10.1097/00004397-199903940-00005.
3. Jampol LM, Becker KG. White spot syndromes of the retina: a hypothesis based on the common genetic hypothesis of autoimmune/inflammatory disease[J]. Am J Ophthalmol, 2003, 135(3): 376-379. DOI: 10.1016/S0002-9394(02)02088-3.
4. Gross NE, Yannuzi LA, Freund KB, et al. Multiple evanescent white dot syndrome[J]. Arch Ophthalmol, 2006, 124(4): 493-500. DOI: 10.1001/archopht.124.4.493.
5. Marsiglia M, Gallego PR, Souza EC, et. al. Expanded clinical spectrum of multiple evanescent white dot syndrome with multimodal imaging[J]. Retina, 2016, 36(1): 64-74. DOI: 10.1097/IAE.0000000000000685.
6. Pichi F, Srvivastava SK, Chexal S, et al. En face optical coherence tomography and optical coherence tomography angiography of multiple evanescent white dot syndrome: new insights into pathogenesis[J]. Retina, 2016, 36(1): 178-188. DOI: 10.1097/IAE.0000000000001255.
7. Smith E, Tran T, Gillies A, et al. Multiple evanescent white dot syndrome following COVID-19 mRNA vaccination in two patients[J]. Ocul Immunol Inflamm, 2022, 30(5): 1240-1243. DOI: 10.1080/09273948.2022.2032198.
8. Crawford CM, Igboeli O. A review of the inflammatory chorioretinopathies: the white dot syndromes[J/OL]. ISRN Inflamm, 2013, 2013: 783190[2013-10-31]. https://europepmc.org/article/MED/24294536. DOI: 10.1155/2013/783190.
9. Tsai L, Jampol LM, Pollock SC, et al. Chronic recurrent multiple evanescent white dot syndrome[J]. Retina, 1994, 14(2): 160-163. DOI: 10.1097/00006982-199414020-00009.
10. Bosello F, Westcott M, Casalino G, et al. Multiple evanescent white dot syndrome: clinical course and factors influencing visual acuity recovery[J]. Br J Ophthalmol, 2022, 106(1): 121-127. DOI: 10.1136/bjophthalmol-2020-317357.
11. Onishi AC, Roberts PK, Jampol LM, et al. Characterization and correlation of "jampol dots" on adaptive optics with foveal granularity on conventional fundus imaging[J]. Retina, 2019, 39(2): 235-246. DOI: 10.1097/IAE.0000000000001958.
12. Dell’Omo R, Wong R, Marino M, et al. Relationship between different fluorescein and indocyanine green angiography features in multiple evanescent white dot syndrome[J]. Br J Ophthalmol, 2010, 94(1): 59-63. DOI: 10.1136/bjo.2009.163550.
13. Yenerel NM, Kucumen B, Gorgun E, et al. A typical presentation of multiple evanescent white dot syndrome (MEWDS)[J]. Ocul Immunol Inflamm, 2008, 16(3): 113-115. DOI: 10.1080/09273940802026060.
14. 陈如, 俞素勤, 邹文军, 等. 多发性一过性白点综合征患眼超广角短波长眼底自身荧光特征[J]. 中华眼底病杂志, 2016, 32(3): 252-256. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.006.Chen R, Yu SQ, Zou WJ, et al. Imaging features of ultra-wide field fundus autofluorescence in multiple evanescent white dot syndrome[J]. Chin J Ocul Fundus Dis, 2016, 32(3): 252-256. DOI: 10.3760/cma.j.issn.1005-1015.2016.03.006.
15. 吴乐正. 光觉[M]//李凤鸣. 中华眼科学. 2版. 北京: 人民卫生出版社, 2005: 305-311.Wu LZ. Photesthesis[M]//Li FM. Chinese ophthalmology. 2nd ed. Beijing: People’s Medical Publishing House, 2005: 305-311.
16. Pereira F, Lima LH, de Azevedo AG, et al. Swept-source OCT in patients with multiple evanescent white dot syndrome[J]. J Ophthalmic Inflamm Infect, 2018, 8(1): 16. DOI: 10.1186/s12348-018-0159-2.
17. Lages V, Mantovani A, Papadia M, et al. MEWDS is a true primary choriocapillaritisand basic mechanisms do not seem to differ from other choriocapillaritis entities[J]. J Curr Ophthalmol, 2018, 30(4): 281-286. DOI: 10.1016/j.joco.2018.09.009.
18. Khochtali S, Dridi T, Abroug N, et al. Swept-source optical coherence tomography angiography shows choriocapillaris flow reduction in multiple evanescent white dot syndrome[J]. J Curr Ophthalmol, 2020, 32(2): 211-215. DOI: 10.4103/JOCO.JOCO_107_20.
19. Russell JF, Pichi F, Scott NL, et al. Masqueraders of multiple evanescent white dot[J]. Int Ophthalmol, 2020, 40(3): 627-638. DOI: 10.1007/s10792-019-01223-4.
20. Kiss S, Damico FM, Young LH. Ocular manifestations and treatment of syphilis[J]. Semin Ophthalmol, 2005, 20(3): 161-167. DOI: 10.1080/08820530500232092.
21. Gass JD, Braunstein RA, Chenoweth RG. Acute syphilitic posterior placoid chorioretinitis. Ophthalmology[J]. Elsevier, 1990, 97(10): 1288-1297. DOI: 10.1016/S0161-6420(90)32418-1.
22. Burkholder BM, Leung TG, Ostheimer TA, et al. Spectral domain optical coherence tomography findings in acute syphilitic posterior placoid chorioretinitis[J]. J Ophthalmic Inflamm Infect, 2014, 4(1): 2. DOI: 10.1186/1869-5760-4-2.
23. Eandi CM, Neri P, Adelman RA, et al. Acute syphilitic posterior placoid chorioretinitis: report of a case series and comprehensive review of the literature[J]. Retina, 2012, 32(9): 1915-1941. DOI: 10.1097/IAE.0b013e31825f3851.
24. Golshani C, Gal-Or O, Giovinazzo V, et al. An elderly patient with acute transient outer retinal disruption resembling bilateral multiple evanescent white dot syndrome[J]. Retin Cases Brief Rep, 2020, 14(2): 131-136. DOI: 10.1097/ICB.0000000000000665.
25. Veronese C, Maiolo C, Morara M, et al. Bilateral multiple evanescent white dot syndrome[J]. Int Ophthalmol, 2018, 38(5): 2153-2158. DOI: 10.1007/s10792-017-0673-5.
26. Tsui E, Gal-Or O, Ghadiali Q, et al. Multimodal imaging adds new insights into acute syphilitic posterior placoid chorioretinitis[J]. Retin Cases Brief Rep, 2018, 12(1): 3-8. DOI: 10.1097/ICB.0000000000000645.
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