“En-Face” Spectral-Domain Optical Coherence Tomography Findings in Multiple Evanescent White Dot Syndrome

Abstract

Purpose. The recent use of “en-face” enhanced-depth imaging spectral-domain optical coherence tomography (EDI SD-OCT) helps distinguish the retinal layers involved in the physiopathology of multiple evanescent white dot syndrome (MEWDS). Methods. Four patients presenting with MEWDS underwent a comprehensive ocular examination including C-scan (“en-face”) EDI SD-OCT at the initial visit and during follow-up. Results. C-scans combined with the other multimodal imaging enabled the visualization of retinal damage. Acute lesions appeared as diffuse and focal disruptions occurring in the ellipsoid and interdigitation zones. The match between autofluorescence imaging, indocyanine green angiography, and “en-face” OCT helped identify the acute microstructural damages in the outer retina further than the choroid. Follow-up using “en-face” EDI-OCT revealed progressive and complete recovery of the central outer retinal layers. Conclusion. “En-face” EDI SD-OCT identified the site of initial damage in MEWDS as the photoreceptors and the interdigitation layers rather than the choroid. Moreover, “en-face” OCT is helpful in the follow-up of these lesions by being able to show the recovery of the outer retinal layers.

Multimodal imaging findings in ‘hyper-early’ stage MEWDS

“…Major articles since have described the multimodal imaging aspects of MEWDS: indocyanine green angiography (ICGA)3 4 showing late hypofluorescent spots and dots; optical coherence tomography (OCT)5 and en-face OCT6 showing disruption of the ellipsoid zone (EZ); and fundus autofluorescence (FAF)7 8 showing hyperautofluorescent lesions.…”

“…The anatomical site of the lesions in MEWDS is now acknowledged to be the junction of the outer–inner segments of the photoreceptors, or EZ, as shown by OCT and en-face OCT 6 9. However, the sequence of OCT lesions is unknown and the overall pathophysiology of MEWDS remains poorly understood.…”

En-Face Optical Coherence Tomography Imaging in a Case of Choroidal Rupture

“…3 En-face OCT imaging enables precise descriptions of the location and depth of the pathology because of the ability to select the thickness and the depth when constructing the slice of the en-face images. [3][4][5][6] In the current case, the rupture and even a hemorrhagic retinal detachment were detected by selecting the depth around the level of the RPE.…”

Ellipsoid zone on optical coherence tomography: a review

“…The international nomenclature consensus panel recommended the second hyper‐reflective band be termed as the ellipsoid zone (EZ), as it avoids attribution of the OCT feature specifically to a single anatomic structure until more definitive evidence becomes available, and this paper will use this terminology throughout. Despite the lack of consensus of the actual origin of the EZ, there has been much interest in its appearance particularly evaluating its integrity and intensity in different disease processes . In this review paper, we provided an overview of the EZ and its clinical and research applications.…”

“…Despite the lack of consensus of the actual origin of the EZ, there has been much interest in its appearance particularly evaluating its integrity and intensity in different disease processes. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] In this review paper, we provided an overview of the EZ and its clinical and research applications.…”