Indocyanine Green Angiographic Aspects of Multiple Evanescent White Dot Syndrome

Obana, Akira; Kusumi, Masayo; Miki, Tokuhiko

doi:10.1097/00006982-199616020-00002

Cited by 70 publications

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“…1 Subsequent development of new imaging technology has added further observations. In 1996, Obana et al 2 reported the indocyanine green angiography (ICGA) findings in 4 cases of MEWDS showing no abnormal signs in the early phase of the angiogram, with hypofluorescence of the lesions in the late phases in the posterior pole and the midperipheral fundus ( Figure 3). A greater number of lesions were noted with ICGA than were evident clinically.…”

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confidence: 99%

Expanded Clinical Spectrum of Multiple Evanescent White Dot Syndrome With Multimodal Imaging

Marsiglia

Gallego-Pinazo

Souza

et al. 2016

Retina

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Purpose: To evaluate and characterize multiple evanescent white dot syndrome abnormalities with modern multimodal imaging modalities.Methods: This retrospective cohort study evaluated fundus photography, fluorescein angiography, indocyanine green angiography, optical coherence tomography, enhanced depth imaging optical coherence tomography, short-wavelength autofluorescence, and near-infrared autofluorescence.Results: Thirty-four multiple evanescent white dot syndrome patients with mean age of 28.7 years were studied (range, 14-49 years). Twenty-six patients were women, and eight were men. Initial mean visual acuity was 0.41 logMAR. Final mean visual acuity was 0.03 logMAR. Fluorescein angiography shows a variable number of mid retinal early fluorescent dots distributed in a wreathlike pattern, which correlate to fundus photography, fundus autofluorescence, and indocyanine green angiography. Indocyanine green angiography imaging shows the dots and also hypofluorescent, deeper, and larger spots, which are occasionally confluent, demonstrating a large plaque of deep retinal hypofluorescence. Optical coherence tomography imaging shows multifocal debris centered at and around the ellipsoid layer, corresponding to the location of spots seen with photography, indocyanine green angiography, and fluorescein angiography. Protrusions of the hyperreflectant material from the ellipsoid layer toward the outer nuclear layer correspond to the location of dots seen with photography, indocyanine green angiography, and fluorescein angiography.Conclusion: Multimodal imaging analysis of the retina in patients with multiple evanescent white dot syndrome shows additional features that may help in the diagnosis of the disease and in further understanding its etiology. Multiple evanescent white dot syndrome is predominantly a disease of the outer retina, centered at the ellipsoid zone, but also involving the interdigitation zone and the outer nuclear layer.RETINA 36: [64][65][66][67][68][69][70][71][72][73][74] 2016

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confidence: 99%

Expanded Clinical Spectrum of Multiple Evanescent White Dot Syndrome With Multimodal Imaging

Marsiglia

Gallego-Pinazo

Souza

et al. 2016

Retina

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“…Besides FA, other complementary exams can reveal MEWDS-like lesions, including indocyanine green angiography and autofluorescence exams showing hypocyanescent and hypo-autofluorescent lesions, respectively, which correspond to the white dots and other lesions not detected during ophthalmoscopic examination (8)(9)(10)(11) . OCT has been used to study the MEWDS macular lesions, to demonstrate that all abnormalities at the inner-outer photoreceptor segments recovered during the course of the disease (12) .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of MEWDS-like lesions with fluorescein angiography and its frequency at an ophthalmic emergency department in Rio de Janeiro

Dias

Morizot

2015

Arquivos Brasileiros De Oftalmologia

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Avaliação de lesões com as características MEWDS ao exame de angiografia fluoresceínica e sua prevalência em serviço de emergência oftalmológica no Rio de Janeiro Results: Among the 6,111 angiographies analyzed, 15 MEWDS cases were detected; the patients ranged in age from 13 to 42 years old, and the male/female ratio was 60% to 40% (nine male and six female). The most common FA aspects included hyperfluorescent dots, dots and spots in the retinal mid-periphery, and foveal granularity in 46% of the cases. Conclusions: MEWDS has a good prognosis, with spontaneous involution, which makes it difficult to diagnose because of the delayed access to ophthalmological assistance, in special FA examination, which highlights the lesions. This study was possible due to the quick access facility at a private ophthalmic emergency department and examination by an experienced ophthalmologist, along with complementary diagnosis by FA and better perception of the patients, thus ensuring good prognosis.

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“…However, the intraluminal dye is washed out in the late phase; ICG dye in the interstitial tissue is seen as homogeneous background fluorescence [11]. The areas of choriocapillaris occlusion are hypofluorescent in the late-phase ICGA in various retinochoroidal diseases [12,13,14]. PDT induces choriocapillaris occlusion [15], which is seen as hypofluorescence of the choriocapillaris from the early to the late phases of ICGA [8,16].…”

Section: Discussionmentioning

confidence: 99%

Protective Effect of Intravitreal Bevacizumab and Sub-Tenon Triamcinolone Acetonide against Occlusion of Choriocapillaris Induced by Photodynamic Therapy

Mukai

Kishi²,

Sato³

et al. 2010

Ophthalmologica

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Purpose: To evaluate the protective effect of intravitreal bevacizumab (IVB) and sub-Tenon triamcinolone acetonide (TA) against choriocapillaris occlusion induced by photodynamic therapy (PDT). Methods: This prospective, nonrandomized, consecutive study included 80 eyes of 80 patients with polypoidal choroidal vasculopathy who underwent an initial PDT. The posttherapeutic follow-up periods were more than 3 months (mean, 9.3 months). Patients were divided into three groups consecutively: the PDT group included 21 eyes of 21 patients treated with only PDT, the TA group included 32 eyes of 32 patients treated with PDT and a sub-Tenon injection of 20 mg TA, and the IVB group included 27 eyes of 27 patients treated with PDT and an intravitreal injection of 1.25 mg bevacizumab. Indocyanine green angiography (ICGA) was performed before and 3 months after PDT. The degree of choriocapillaris occlusion was assessed in the marginal zone of the PDT area based on the background hypofluorescence seen on ICGA quantified by densitometry (Imagenet). Results: ICGA at 1 and 5 min showed hypofluorescence in the marginal zone in all eyes 3 months after PDT. The hypofluorescence became indistinguishable from the background fluorescence 15 min after treatment in some eyes; however, the relative hypofluorescence persisted in some cases. The rates of fluorescence intensity in the marginal zone compared to those in the untreated area, i.e. the percentage of baseline fluorescence, were 0.60, 0.65 and 0.73 at 1, 5 and 15 min after dye injection in the PDT group, respectively, 0.64, 0.68 and 0.82 in the TA group, and 0.64, 0.73 and 0.90 in the IVB group. The intensity of the fluorescence was significantly (p < 0.05) higher in the TA group at 15 min and in the IVB group at 1, 5 and 15 min compared with the PDT group. Conclusions: IVB and TA reduced choriocapillaris occlusion after PDT. IVB appeared to have a stronger protective effect than TA in this therapeutic regimen.

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Indocyanine Green Angiographic Aspects of Multiple Evanescent White Dot Syndrome

Cited by 70 publications

References 0 publications

Expanded Clinical Spectrum of Multiple Evanescent White Dot Syndrome With Multimodal Imaging

Expanded Clinical Spectrum of Multiple Evanescent White Dot Syndrome With Multimodal Imaging

Evaluation of MEWDS-like lesions with fluorescein angiography and its frequency at an ophthalmic emergency department in Rio de Janeiro

Protective Effect of Intravitreal Bevacizumab and Sub-Tenon Triamcinolone Acetonide against Occlusion of Choriocapillaris Induced by Photodynamic Therapy

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