Multiple evanescent white dot syndrome (MEWDS) is part of a spectrum of disease entities known as acute zonal occult outer retinopathy-complex that share photoreceptor disruption as a cardinal feature. Optical coherence tomography (OCT) allows for qualitative assessment of the integrity of the photoreceptor layer via examination of the junction between the photoreceptor inner and outer segments. A patient with atypical MEWDS who demonstrated disruption of the inner segment/outer segment junction during the acute phase of the disease is described. The change in photoreceptor architecture and abnormalities on fundus autofluorescence imaging and microperimetry were restored to normal following resolution of the disease. Using a novel OCT-based method of quantitatively measuring photoreceptor outer segment length, the authors show that photoreceptor outer segment length appears decreased acutely with restoration to normal following disease resolution. OCT can assess photoreceptor recovery, both qualitatively and quantitatively, in patients with MEWDS features.
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