To describe features characteristic of multiple evanescent white dot syndrome (MEWDS) using adaptive optics scanning laser ophthalmoscopy (AOSLO).
Six women (seven eyes) who presented with MEWDS between June 2014 and April 2017 underwent ophthalmologic examinations and multimodal imaging including infrared, AOSLO, and spectral domain optical coherence tomography.
Bright hyperreflective lesions on AOSLO throughout the course of MEWDS could be correlated to the hyperreflective dots of foveal granularity on infrared imaging without apparent corresponding changes on spectral domain optical coherence tomography. During the acute phase of MEWDS, extrafoveal hyperreflective dots were also visible on AOSLO and infrared and were associated with accumulations of hyperreflective material above the retinal pigment epithelium on spectral domain optical coherence tomography.
Foveal granularity on conventional fundus imaging could be correlated with hyperreflective lesions visible on AOSLO. We hypothesize that these hyperreflective lesions, “Jampol dots,” are the foveal corollaries of the same process associated with the classic “dot” lesions in MEWDS. Based on the intact photoreceptor mosaic on AOSLO, we surmise that this material is accumulating at the level of the retinal pigment epithelium.
Using adaptive optics scanning laser ophthalmoscopy and multimodal imaging of foveal “Jampol dots” in multiple evanescent white dot syndrome, we show that these hyperreflective lesions are visible on adaptive optics scanning laser ophthalmoscopy, correlating to hyperreflective dots of foveal granularity on infrared reflectance imaging, without clinically detectable changes on optical coherence tomography. Adaptive optics scanning laser ophthalmoscopy shows an intact overall photoreceptor mosaic, leading us to surmise that the likely locations of these deposits and “dots” are at the level of the retinal pigment epithelium.
*Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and
†Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Reprint requests: Amani A. Fawzi, MD, Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, 645 N Michigan Avenue no. 440, Chicago, IL 60611; e-mail: firstname.lastname@example.org
Instrument support was provided by Boston Micromachines Corporation. The funding agencies had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
None of the authors has any conflicting interests to disclose.