First Author: I.Careba UK
Co Author(s): G. De Salvo
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To describe two cases of MEWDS studied with multimodal imaging and to highlight their clinical features both at presentation and follow-up.
Ophthalmology Clinic, Southampton University Hospital
Two retrospective cases of MEWDS(28 year old female and 23 year old male),who presented with associated atypical clinical features and abnormal investigations. Multimodal imaging was used to investigate these cases: Multicolour (MC), spectral domain optical coherence tomography (OCT), autofluoresecnce(AF), fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA).
A multimodal approach allowed us to make a certain diagnosis of MEWDS. For the first patient, AF showed hyperautofluorescent areas spread along the retina. MC showed greyish hyporeflectance spread throughout the retina (lesions were better seen than in the correspondent IR image). FFA showed early masking, late staining and hot disc. ICGA showed hypofluorescent lesions seen throughout the retina. OCT showed disruption of the ellipsoid layer and external limiting membrane. For the second patient, AF showed hyperautofluorescent areas spread along the retina. MC showed multiple areas of hyporeflectivity at the macula (lesions were better seen than in the correspondent IR image). FFA showed early masking of the lesions with late staining. ICGA was not done, patient being allergic to seafood. OCT showed disruption and increased thickness of the ellipsoid layer at macula.
We suggest that a multimodal imaging approach could effectively demonstrate the anatomic characteristics of the disease, thus helping to make a correct diagnosis of MEWDS in order to avoid multiple expensive and invasive systemic investigations.