PMC4590319_01
Photographs of the right eye in a patient with multiple evanescent white dot syndrome (Case 1) at the initial visit (A-E) and 3 months later (F).. Notes: (A and B) Funduscopy showing multiple, faint, subretinal white dots extending from the posterior pole to the midperiphery (A and B, white arrowheads), with foveal granularity. Retinal vascular sheathing was also observed in the temporal midperiphery (B, arrows). (C) Late-phase fluorescein angiography showing faint hyperfluorescence corresponding to the white dots (arrowheads) and retinal vascular wall staining with leakage corresponding to the retinal sheathing (arrows). (D) On late-phase indocyanine green angiography, multiple hypofluorescent spots scattered over a wider area than the white dots were seen (arrowheads). (E) A horizontal EDI-OCT image through the fovea revealed the discontinuity of ellipsoid zone at macular area corresponding to the white dots (arrows). SCT was 295 microm. (F) The ellipsoid zone at the macula spontaneously restored, and the SCT decreased to 237 microm.. Abbreviations: EDI-OCT, enhanced depth imaging optical coherence tomography; SCT, subfoveal choroidal thickness.
imcrj-8-209Fig1.jpg
PMC4590319_01_imcrj-8-209Fig1.jpg
f1-imcrj-8-209
Funduscopic examination showed multiple, faint, subretinal white dots at the posterior pole to the equator and macular granular change (Figure 1A and B, arrowheads). In addition, retinal vascular sheathing was observed at the midperiphery (Figure 1B, arrows). Fluorescein angiography (FA) showed hyperfluorescence continuing from the initial phase corresponding to the white dots (Figure 1C, arrowheads) and the staining of the optic disk. The retinal sheathing sites showed vascular staining with leakages in the late-phase OD (Figure 1C, arrows). Indocyanine green angiography showed no abnormal appearance in the initial phase and multiple hypofluorescence at the wider area than the white dots (Figure 1D, arrowheads). Enhanced depth imaging optical coherence tomography (EDI-OCT) revealed the discontinuity of the ellipsoid zone at macular area OD (Figure 1E, arrows) and that the subfoveal choroidal thickness (SCT) was 295 microm. OD (Figure 1F). On Humphrey perimetry, the MD value improved to -0.28 dB OD and -0.69 dB OS.
PMC4590319_02
Photographs of the right eye in a patient with multiple evanescent white dot syndrome (Case 2) at the initial visit (A-E) and 3 months later (F).. Notes: (A and B) Funduscopy showing multiple, faint, subretinal white dots extending from the posterior pole to the midperiphery (A and B, white arrowheads), with foveal granularity. Retinal vascular sheathing was also observed in the temporal midperiphery (B, arrows). (C) Late-phase fluorescein angiography showing faint hyperfluorescence corresponding to the white dots (arrowhead) and vascular leakage from the retinal sheathing site (arrow). (D) Late-phase indocyanine green angiogram images showing multiple hypofluorescent spots scattered over a wider area than the white dots (arrowheads). (E) A horizontal EDI-OCT image through the fovea revealed the discontinuity of the ellipsoid zone at macular area corresponding to the white dots. SCT was 341 microm. (F) Macular ellipsoid zone spontaneously restored with the decrease of SCT (319 microm).. Abbreviations: EDI-OCT, enhanced depth imaging optical coherence tomography; SCT, subfoveal choroidal thickness.
imcrj-8-209Fig2.jpg
PMC4590319_02_imcrj-8-209Fig2.jpg
f2-imcrj-8-209
Funduscopic examination showed multiple, faint, small, subretinal white dots at the posterior pole to the midperiphery (Figure 2A and B, arrowheads), macular granularity, and retinal vascular sheathing at superotemporal midperiphery (Figure 2B, arrows). On FA, the hyperfluorescence was seen from the initial phase corresponding to the white dots (Figure 2C, arrowhead), with the staining of the optic disk and vascular leakages corresponding to the retinal vascular sheathing on the late phase (Figure 2C, arrow). On late-phase indocyanine green angiography, multiple spots of hypofluorescence were observed at the wider area despite no initial abnormal findings (Figure 2D, arrowheads). EDI-OCT revealed segmental loss of the ellipsoid zone at areas of the white dots (Figure 2E, arrows), and the SCT was 341 microm. Three months after the initial visit, the ellipsoid zone at the macula restored and the SCT decreased to 319 microm (Figure 2F).