Objective To observe the characteristics of multiple evanescent white dot syndrome (MEWDS) with modern multimodal imaging modalities. Methods This was a retrospective case study. Eleven patients (11 eyes) diagnosed with MEWDS were enrolled. There were 10 females and 1 male, mean age was 27.6 years (range 15-41 years). The period between disease onset and visiting to the hospital was between 2 to 13 days, the average time was 4.7 days. All the patients underwent examinations of best corrected visual acuity, slit-lamp biomicroscope, indirect ophthalmoscope, fundus color photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (SD-OCT). The mean follow up duration was 3.2 months. The imaging characteristics were compared. Results Fundus color photography showed foveal orange-red granularity in all eyes. FAF showed strong autofluorescence with a vague boundary. FFA showed a variable number of highly fluorescent fine needle-like dots arranged in a ring in the early stage, and fluorescence remained in the late stage. ICGA showed advanced lesions of vague boundary merged into a large plaque of deep retinal hypofluorescence. SD-OCT showed the hyperreflectant material deposit over the retinal pigment epithelium and extending anteriorly through the interdigitation zone, ellipsoid layer, and toward the external limiting membrane. At the site of extrafoveal lesions, SD-OCT revealed the presence of discontinuities or disruptions centered on the ellipsoid zone to include the interdigitation. Conclusions In MEWDS patients, fundus photography showed foveal orange-red granularity; FFA showed early fluorescent dots distributed in a ring pattern; ICGA showed hypofluorescent lesions in the later stage; SD-OCT showed disruption of the interdigitation zone and ellipsoid zone and accumulations of hyperreflective material that was of variable size and shape; FAF showed strong autofluoresce areas that correlated to spots observed with FFA and ICGA.
ObjectiveTo use flash electroretinogram (F-ERG) and optical coherence tomography (OCT) to examine patients with primary retinitis pigmentosa (RP), and analyze the specificity of the disease on F-ERG and OCT. MethodsThirty-seven patients (74 eyes) diagnosed with primary retinitis pigmentosa in the Department of Ophthalmology, West China Hospital between September 2013 to October 2014 and 38 normal volunteers (76 eyes) were included in this study. F-ERG and OCT examinations were performed on all the patients. Then, we analyzed the differences between the two groups of subjects. ResultsFor RP patients undergoing P-ERG examination with the dark adaptation of 0.01 ERG, the latency of b wave was (73.24±6.42) ms and the amplitude of b wave was (22.87±22.48) μV; when dark adaptation of 3.0 ERG was adopted, the latency of a wave was (24.57±6.30) ms, the amplitude of a wave was (35.45±25.54) μV, the latency of b wave was (48.19±8.18) ms, and the amplitude of b wave was (119.47±50.89) μV; with the light adaptation of 3.0 ERG, the latency of a wave was (21.01±4.86) ms, the amplitude of a wave was (12.59±13.43) μV, the latency of b wave was (38.43±5.00) ms, and the amplitude of b wave was (27.19±38.12) μV. For normal volunteers undergoing F-ERG examination with the dark adaptation of 0.01 ERG, the latency of b wave was (72.63±3.49) ms and the amplitude of b wave was (86.36±21.57) μV; when the dark adaptation was 3.0 ERG, the latency of a wave was (22.88±1.62) ms, the amplitude of a wave was (210.74±43.57) μV, the latency of b wave was (42.59±2.60) ms, and the amplitude of b wave was (398.29±62.42) μV; when the light adaptation of 3.0 ERG was adopted, the latency of a wave was (16.61±0.87) ms, the amplitude of a wave was (54.26±19.64) μV, the latency of b wave was (33.29±1.11) ms, and the amplitude of b wave was (176.98±63.44) μV. There were no significant differences between the two groups when dark adaptation ERG was 0.01 (P=0.48), but for other adaptations, there were significant differences in the latency and amplitude of a and b wave between the two groups (P<0.05). The results of OCT showed that the retinal thickness of the RP patients with a range of 1 mm diameter centered on macular center concave was (218.66±74.14) mm, 3 mm diameter was (275.03±47.85) mm, and 6 mm diameter was (247.37±46.44) mm. For normal volunteers, OCT showed that the retinal thickness with a 1 mm range centered on macular center concave was (250.38±15.79) mm, 3 mm was (323.64±17.26) mm, and 6 mm was (283.44±12.50) mm. The differences between the two groups were statistically significant for each range (P<0.01). ConclusionFor patients with RP, F-ERG shows latency delay and amplitude decrease for each response, while OCT displays a thinning thickness of macular fovea. Therefore, F-ERG and OCT can not only effectively evaluate the functions of macular and the surrounding retina, but can also be used as an effective method for the diagnosis of RP.