The optical imaging features and clinical significances of the multiple evanescent white dot syndrome

Objective To explore the clinical manifestations and treatment of the multiple evanescent white dot syndrome (MEWDS).Methods We retrospectively analyzed the clinical data of 8 patients diagnosed as MEWDS during the period from Jan.2009 to Dec.2010 in our department and reviewed their clinical features.Results All the MEWDS patients of 8 cases were monocular disease,3 patients were male and 5 female patients.The average age was 33 years (19-48 years).The mean onset time was 6.5 days (2-12 days).The average corrected visual acuity at the first visit was 0.54 (0.15-0.8).The vitreous had inflammatory cells in all the patients.And all the patients were found white circular punctate lesions located in the deep retina by fundus examination,the size of the lesion about 50-500 μm,with unclear boundary and flat surface,3 cases (37.5％) with optic disc hyperemia.The early of FFA,the white dots of all patients showed round hyperfluorescence making up of granular focus,and strong staining then in the later; in which 4 cases (50％) with hyperfluorescence in optic and 3 cases (37.5％) with segmental vascular leakages.In ICGA,8 eyes (100％) showed normal almost in the early stage,but in the later stage,there were many scattered or distributed hypofluorescent spots with clear-border located in the posterior fundus,which were correspond with the distribution characteristic of the choriocapillaris lobular.OCT showed the inner segment/outer segment (IS/OS)layer reflective disorder in which the white dots corresponding,some even completely disappeared.Post-treatment by low-dose glucocorticoid,all patients were completely cured.Conclusions MEWDS are inflammatory diseases,with quick onset and moderate impairment of visual function,and good prognosis.FFA and ICGA have important value in diagnosis and differential diagnosis,but OCT has important significance in the follow-up observation to the MEWDS. Key words: White dot syndrome;  FFA;  ICGA;  OCT