Multiple evanescent white dot syndrome (MEWDS): update on practical appraisal, diagnosis and clinicopathology; a review and an alternative comprehensive perspective

Papasavvas I., Mantovani A., Tugal-Tutkun I., Herbort C. P.

JOURNAL OF OPHTHALMIC INFLAMMATION AND INFECTION, cilt.11, sa.1, 2021 (ESCI) identifier identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 11 Sayı: 1
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1186/s12348-021-00279-7
  • Dergi Adı: JOURNAL OF OPHTHALMIC INFLAMMATION AND INFECTION
  • Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, EMBASE, Directory of Open Access Journals
  • Anahtar Kelimeler: MEWDS, ICGA, PICCPs, BL-FAF, INDOCYANINE GREEN ANGIOGRAPHY, OPTICAL COHERENCE TOMOGRAPHY, BLIND SPOT ENLARGEMENT, PLACOID PIGMENT EPITHELIOPATHY, OCCULT OUTER RETINOPATHY, FUNDUS AUTOFLUORESCENCE, CHOROIDAL NEOVASCULARIZATION, FOLLOW-UP, CHORIOCAPILLARIS, SPECTRUM
  • İstanbul Üniversitesi Adresli: Evet

Özet

Background Multiple evanescent white dot syndrome (MEWDS) is a rare inflammatory eye condition affecting the outer retina as a consequence of choriocapillaris non perfusion. The pathophysiology of MEWDS will be discussed based clinical appraisal and on multimodal imaging appraisal. Methods Narrative review and perspective opinion. Results Literature review results helped us to put forward (1) the specific symptomatology (decreased/blurred vision, photopsia, subjective scotomas), (2) the ill-asserted character of clinical findings (foveal granularity, white dots in fundoscopy), (3) and the crucial importance of multimodal imaging with the diagnostic triad of ICGA hypofluorescent areas, BL-FAF hyperautofluorescent areas and loss/damage of IS/OS-ellipsoid zone on SD-OCT that characterise the disease and can practically help the clinician to diagnose MEWDS. A comprehensive alternative perspective of the disease was formulated. Conclusions The bulk of evidence that we are presenting in this review, thanks to new performing non-invasive and invasive imaging modalities, is sufficiently compelling to consider MEWDS as a primary choriocapillaritis/inflammatory choriocapillaropathy. Multimodal imaging allows the clinician to diagnose MEWDS with a high level of certainty and ensures a precise follow-up.