Primary Multiple Evanescent White Dot Syndrome and Multiple Evanescent White Dot Syndrome Secondary to Multifocal Choroiditis/Punctate Inner Choroidopathy

Meng, Yang; Zhang, Qi; Li, Lü; Yi, Zuohuizi; Xu, Yishuang; Su, Yu; Liang, Congbi; Xiao, Dingquan; Zhang, Lu; Chen, Changzheng

doi:10.1097/iae.0000000000003776

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Essilfie et al [10] recently proposed a term, secondary MEWDS, that may be triggered by a macular disease or iatrogenic injury, distinguishing from the primary MEWDS described by Jampol [1] . Secondary MEWDS refers to classical MEWDS features triggered by choroidal antigen exposure after varied causes and diseases possibly disrupting the retinal pigment epithelium-Bruch membrane-choriocapillariscomplex (RPE-BrM-CC) [11][12][13][14] . They believed that secondary MEWDS seems to be an epiphenomenon that may be seen in diseases disruptive to RPE-BrM-CC.…”

Section: Introductionmentioning

confidence: 99%

Clinical features and possible pathogenesis of multiple evanescent white dot syndrome with different retinal diseases and events: a narrative review

Chen,

Zhang,

Wang

et al. 2024

Int J Ophthalmol

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Multiple evanescent white dot syndrome (MEWDS) is a rare fundus disease, characterized by acute vision loss and visual field defects. Many previous studies have explained the possible pathogenesis and clinical features of primary MEWDS. However, as the number of reported cases increases, secondary MEWDS occurs in other related retinal diseases and injuries, exhibiting some special characteristics. The associated retinal diseases include multifocal choroiditis/punctate inner choroidopathy (MFC/PIC), acute zonal occult outer retinopathy, best vitelliform macular dystrophy, pseudoxanthoma elasticum, and ocular toxoplasmosis. The related retinal injury is laser photocoagulation, surgery, and trauma. Although primary MEWDS often have a self-limiting course, secondary MEWDS may require treatment in some cases, according to the severity of concomitant diseases and complications. Notably, MEWDS secondary to MFC/PIC that is prone to forming choroidal neovascularization and focal choroidal excavation, needs positive treatment with corticosteroids. The possible underlying pathogenesis of secondary MEWDS is the exposure of choroidal antigen after the disruption of Bruch’s membrane. The MEWDS-related features in secondary MEWDS are still evanescent under most circumstances. Its prognosis and treatment depend on the severity of complications. Current studies propose that the etiology is associated with immune factors, including viral infection, inflammation in choroid and Bruch’s membrane, and antigen exposure caused by retinal and/or choroidal insults. More pathogenic studies should be conducted in the future. Accurate diagnosis for secondary MEWDS could benefit patients in aspects of management and prognosis.

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Section: Introductionmentioning

confidence: 99%

Clinical features and possible pathogenesis of multiple evanescent white dot syndrome with different retinal diseases and events: a narrative review

Chen,

Zhang,

Wang

et al. 2024

Int J Ophthalmol

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The multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy lesion with multiple evanescent white dot syndrome-like features: a retrospective study

Chen,

Cheng,

Zhang

et al. 2024

BMC Ophthalmol

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Background Multiple evanescent white dot syndrome (MEWDS)-like features is a rare condition triggered by a macular disease or iatrogenic injury, exhibiting MEWDS changes in the fundus. This study aims to describe the multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy (MFC/PIC) lesions with MEWDS-like features. Methods Six cases were studied retrospectively. All cases were given regional and oral corticosteroids. Results All cases showed an isolated juxtafoveal yellowish-white MFC/PIC lesion with disruption of RPE-Bruch’s membrane-choriocapillaris complex (RPE-BM-CC), subretinal hyperreflective materials and choroidal thickening on optical coherence tomography. Two weeks after presentation, the grayish-white dots disappeared spontaneously and the corticosteroids were given. After four weeks, the ellipsoid zone (EZ) around the lesion and hyper-autofluorescence resolved. After 13 weeks, five cases showed shrinkage of the juxtafoveal lesion and restoration of foveal EZ. After six months, the juxtafoveal lesion became pigmented. Only one case developed type 2 choroidal neovascularization. Conclusions The clinical course of MEWDS-like manifestations is still evanescent in our cases. The yellowish-white juxtafoveal MFC/PIC lesions with disruption of RPE-BM-CC and choroidal thickening showed a well-controlled prognosis after corticosteroid treatment.

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Primary Multiple Evanescent White Dot Syndrome and Multiple Evanescent White Dot Syndrome Secondary to Multifocal Choroiditis/Punctate Inner Choroidopathy

Cited by 2 publications

References 29 publications

Clinical features and possible pathogenesis of multiple evanescent white dot syndrome with different retinal diseases and events: a narrative review

Clinical features and possible pathogenesis of multiple evanescent white dot syndrome with different retinal diseases and events: a narrative review

The multimodal imaging features and outcomes of multifocal choroiditis/punctate inner choroidopathy lesion with multiple evanescent white dot syndrome-like features: a retrospective study

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