Multiple Evanescent White Dot Syndrome Research Articles

Clinical Features of Pregnancy-associated Retinal and Choroidal Diseases Causing Acute Visual Disturbance.

PurposeTo report clinical features of patients with retinal and choroidal diseases presenting with acute visual disturbance during pregnancy.MethodsIn this retrospective case series, patients who developed acute visual loss during pregnancy (including puerperium) and visited a tertiary hospital from July 2007 to June 2015, were recruited by searching electronic medical records. Patients were categorized according to the cause of visual loss. Clinical features and required diagnostic modalities were analyzed in the retinal and choroidal disease group.ResultsAcute visual loss occurred in 147 patients; 49 (38.9%) were classified into the retinal and choroidal group. The diagnoses included central serous chorioretinopathy (22.4%), hypertensive retinopathy with or without pre-eclampsia (22.4%), retinal tear with or without retinal detachment (18.4%), diabetic retinopathy progression (10.2%), Vogt-Koyanagi-Harada disease (4.1%), retinal artery occlusion (4.1%), multiple evanescent white dot syndrome (4.1%), and others (14.3%). Visual symptoms first appeared at gestational age 25.9 ± 10.3 weeks. The initial best-corrected visual acuity (BCVA) was 0.27 ± 0.39 logarithm of the minimum angle of resolution (logMAR); the final BCVA after delivery improved to 0.13 ± 0.35 logMAR. Serious visual deterioration (BCVA worth than 20 / 200) developed in two patients. Differential diagnoses were established with characteristic fundus and spectral-domain optical coherence tomography findings in all cases.ConclusionsIn pregnant women with acute visual loss, retinal and choroidal diseases are common and could be vision threatening. Physicians should be aware of pregnancy-associated retinal and choroidal diseases and their clinical features. The differential diagnosis can be established with non-invasive techniques.

Choroidal Neovascularization Associated with Multiple Evanescent White Dot Syndrome Treated with Intravitreal Ranibizumab

ABSTRACTPurpose: To describe the clinical outcomes of intravitreal ranibizumab treatment for subfoveal choroidal neovascularization (CNV) associated with multiple evanescent white dot syndrome (MEWDS).Methods: This is a prospective, interventional, case series. All recruited patients underwent a baseline intravitreal ranibizumab injection and were monitored monthly over a 12-month follow-up, following a pro-re-nata regimen.Results: Four patients (four eyes) were included in the study. Mean best-corrected visual acuity (BCVA) changed from 0.60 ± 0.20 at baseline to 0.07 ± 0.05 logMAR at 12-month examination. Baseline central macular thickness reduced from 330 ± 32 µm to the final value of 228 ± 14 µm at the 1-year follow-up. Overall, a mean number of 2.2 ranibizumab injections were administered at the end of 12 months.Conclusions: Intravitreal ranibizumab treatment represents a valuable therapeutic option for the management of CNV associated with MEWDS.

Choroidal neovascularization as the initial manifestation of multiple evanescent white dot syndrome

Glaucoma is characterized by the progressive degeneration of the optic nerve head (ONH) and retinal ganglion cells (RGCs). RGCs can be divided into basic regions, including the axon and synapse, the dendritic arbor, and the cell body (1). These compartments can independently be affected by degeneration processes and cause damage of the ONH (1,2).

A new electroretinogram function that can move the centre of the multifocal hexagonal stimulus array

PurposeWe can examine declines in visual sensitivity at arbitrary points on the retina using a precise perimetry device with a fundus camera function. However, the retinal layer causing the decline in visual sensitivity can not be identified. To investigate cryptogenic diseases, such as macular dystrophy, acute zonal occult outer retinopathy and multiple evanescent white dot syndrome, we studied a new electroretinogram function that can move the centre of the multifocal hexagonal stimulus array.MethodsAn electroretinographic optical system, specifically perimetric optical system, was added to an experimental device with the same optical system as a fundus camera. We also added an Edmund infrared camera EO‐0413, a lens with a focal length of 25 mm, a 45‐degree cold mirror, a halogen lamp and an 8‐inch monitor. Software was generated to show the multifocal hexagonal stimulus array on the monitor using C++Builder XE8 and to move the centre of the array up and down as well as back and forth. We used National Instruments’ USB‐6008 and their system design platform LabVIEW 2015 for data retrieval. The Nihon Kohden plate electrode NE‐113As were used to measure electrodermal activities around the eyes. Some contact lens electrodes were used to measure electrical potentials of retina.ResultsWe used a multifocal hexagonal stimulus array with 37 elements in the software. The centre of the multifocal hexagonal stimulus array could be adjusted to the same position as the examination target of the precise perimetry.ConclusionsWe successfully added this new electroretinogram function to the experimental ophthalmologic device.

Characteristics of multiple evanescent white dot syndrome with multimodal imaging

Objective To observe the characteristics of multiple evanescent white dot syndrome (MEWDS) with modern multimodal imaging modalities. Methods This was a retrospective case study. Eleven patients (11 eyes) diagnosed with MEWDS were enrolled. There were 10 females and 1 male, mean age was 27.6 years (range 15 - 41 years). The period between disease onset and visiting to the hospital was between 2 to 13 days, the average time was 4.7 days. All the patients underwent examinations of best corrected visual acuity, slit-lamp biomicroscope, indirect ophthalmoscope, fundus color photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA) and spectral domain optical coherence tomography (SD-OCT). The mean follow up duration was 3.2 months. The imaging characteristics were compared. Results Fundus color photography showed foveal orange-red granularity in all eyes. FAF showed strong autofluorescence with a vague boundary. FFA showed a variable number of highly fluorescent fine needle-like dots arranged in a ring in the early stage, and fluorescence remained in the late stage. ICGA showed advanced lesions of vague boundary merged into a large plaque of deep retinal hypofluorescence. SD-OCT showed the hyperreflectant material deposit over the retinal pigment epithelium and extending anteriorly through the interdigitation zone, ellipsoid layer, and toward the external limiting membrane. At the site of extrafoveal lesions, SD-OCT revealed the presence of discontinuities or disruptions centered on the ellipsoid zone to include the interdigitation. Conclusions In MEWDS patients, fundus photography showed foveal orange-red granularity; FFA showed early fluorescent dots distributed in a ring pattern; ICGA showed hypofluorescent lesions in the later stage; SD-OCT showed disruption of the interdigitation zone and ellipsoid zone and accumulations of hyperreflective material that was of variable size and shape; FAF showed strong autofluoresce areas that correlated to spots observed with FFA and ICGA. Key words: Retinal diseases/diagnosis; Fluorescein angiography; Indocyanine green; Tomography, optical coherence; Diagnostic imaging

Imaging features of ultra-wide field fundus autofluorescence in multiple evanescent white dot syndrome

Objective To observe the imaging features of ultra-wide field short wave fundus autofluorescence (SW-FAF) in eyes with multiple evanescent white dot syndrome (MEWDS), and analysis the correspondence to conventional images. Methods It was a retrospective case series study. Thirteen patients (14 eyes) diagnosed with MEWDS were enrolled. There were 12 females and 1 male, aged from 22 to 57 years, mean age was 34.5 years. All the eyes underwent fundus color photography, optical coherence tomography (OCT) and ultra-wide field autofluorescence (FAF). Simultaneous fundus fluorescein angiography (FFA) and indocyanine green angiography (ICGA) were performed in 6 eyes. The characteristic changes of SW-FAF in studied eyes were observed and compared with the images of FFA and ICGA. All the eyes were followed up every 1 to 2 weeks, with an average of 16.7 weeks. The characteristic images of SW-FAF and corresponding OCT were studied during follow up. Results MEWDS presented with numerous multiple hyper-autofluorescent spots, sized from 50 - 500 μm, with a vague boundary in ultra-wide field SW-FAF. These spots located mainly at the peripapillary area and the posterior pole with a confluent pattern. The lesions extended to the mid-peripheral retina as well and became more scattered. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to that of the greyish-white spots seen in color photograph and the hyper-fluorescent spots detected by FFA. It was consistent with the distribution of hypo-fluorescent spots in late-phase ICGA as well. But the number of the spot showed in FAF is much more than that in FFA, and slightly less than that in ICGA. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina. After the recovery, the hyper-autofluorescent spots disappeared with the outer retina structure repaired completely. Conclusions MEWDS presented with numerous multiple hyper-autofluorescent spots which located mainly at the peripapillary area in ultra-wide field SW-FAF. The distribution of the hyper-autofluorescent lesions in SW-FAF corresponded roughly to color photograph, FFA and ICGA in late-phase. The OCT scans through the hyper-autofluorescent lesions in SW-FAF showed impairment of outer retina. Key words: Retinal diseases/diagnosis; Fluorescein angiography; Indocyanine green; Tomography, optical coherence; Diagnostic imaging

EXPANDED CLINICAL SPECTRUM OF MULTIPLE EVANESCENT WHITE DOT SYNDROME WITH MULTIMODAL IMAGING.

To evaluate and characterize multiple evanescent white dot syndrome abnormalities with modern multimodal imaging modalities. 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. 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. 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.

How could cannabinoids be effective in multiple evanescent white dot syndrome? A hypothesis

How could cannabinoids be effective in multiple evanescent white dot syndrome? A hypothesis

Interpretation of fundus autofluorescence changes in choriocapillaritis: a multi-modality imaging study.

We aimed to describe imaging findings in primary inflammatory choriocapillaropathies (PICCPs) after a photobleaching process. 2Images from six consecutive cases of patients affected by PICCPs (four with multiple evanescent white dot syndrome and two with multifocal choroiditis) were reviewed. Patients underwent fundus autofluorescence (FAF), fluorescein angiography (FA), indocyanine green angiography (ICGA), and spectral-domain optical coherence tomography (SD-OCT) by means of the Spectralis HRA (Heidelberg Engineering, Heidelberg, Germany). FAF images were acquired at the beginning of the examination in partially dark-adapted conditions followed by light adapted conditions. During the active phase of the diseases, all patients showed areas of increased FAF that became isoautofluorescent after photobleaching. Simultaneously with increased FAF, the ICGA showed typical hypofluorescent dark areas that were more evident in the late phase. SD-OCT showed disruptions in the hyper-reflective band at the ellipsoid zone. FAF and SD-OCT are complementary imaging techniques that show alterations in the outer retina of patients affected by PICCPs.

Characteristic of optical coherence tomography image and choroidal thickness in patients with multiple evanescent white dot syndrome

Objective To observe the characteristic of optical coherence tomography (OCT) and subfoveal choroidal thickness(SFCT) in patients with multiple evanescent white dot syndrome (MEWDS). Methods The clinical data of 10 patients (10 eyes)with MEWDS were included in the study. 10 normal subjects with matched age, gender and ocular refractive status was selected as control. The patients including 9 females (9 eyes) and 1 male (1 eye), with the average age of (27±8) years. The onset time ranged from 5 to 14 days. The patients were in acute phase if it was in 2 weeks after onset, or convalescent phase if onset was 8 weeks ago. The corrected vision, slit lamp biomicroscopy, ophthalmoscope, fundus photography, fundus fluorescein angiography, indocyanine green angiography and optical coherence tomography (OCT) were performed alone or combined in all patients. The SFCT between the acute and convalescent phases were measured using enhanced depth imaging OCT. The average follow-up was 5 months. The OCT characteristics of affected eyes between acute and convalescent phase were compared. The SFCT of the affected eyes and fellow eye were compared. Results The foveal inner segment-outer segment (IS/OS) was disrupted, thin, irregular in the acute phase, and restored in the convalescent phase. The SFCT of patients in the acute phase was (239±140.7) μm, in the convalescent phase was (189.9±115.6) μm. The SFCT in the acute phase was more thicker than the convalescent phase (t=5.287, P<0.05). The SFCT of fellow eyes in the acute phase was (214.6±127.2) μm, in the convalescent phase was (186.5±108.6) μm, the difference was significant(t=3.553, P<0.05). The SFCT in the control subject was (155.5±83.5) μm. The SFCT in the acute phase was thicker than the control(Z=-2.117, P<0.05). Conclusions In the acute phase of MEWDS, the foveal IS/OS was disrupted, thin and irregular in OCT scan. The choroid is thicker in the acute phase than in the convalescent phase in both eyes, and thicker than controls. Key words: Retinal diseases/diagnosis; Choroid; Macula lutea; Tomography, optical coherence

Multimodal Imaging in Multiple Evanescent White Dot Syndrome

Multimodal Imaging in Multiple Evanescent White Dot Syndrome

Macular Multifocal Granular Hyperfluorescence on Fluorescein Angiography

Purpose: To investigate the causes of multifocal granular hyperfluorescence at the macula on fluorescein angiography (FA) in Japanese patients. Methods: I retrospectively studied 1,457 consecutive Japanese patients (1,457 eyes) who underwent digital simultaneous FA and indocyanine green angiography (ICGA). Results: One hundred forty-seven of the 1,457 eyes had multifocal granular hyperfluorescence on FA images. Of the 147 eyes, 94 (64%) eyes had polypoidal choroidal vasculopathy (PCV); 25 (17%) eyes had either recurrent or chronic central serous chorioretinopathy (CSC); 19 (13%) eyes had occult choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD); and three (2%) eyes had multiple evanescent white-dot syndrome. No diagnosis was established in 6 (4%) eyes because of the difficulty differentiating chronic CSC, PCV, and occult CNV. Conclusions: The current results showed that PCV, occult CNV, and chronic CSC are the main causes of multifocal granular hyperfluorescence on FA. Thus, clinicians first should consider such disorders when examining patients with scattered lesions with pigment epithelial degeneration on ophthalmoscopy and multifocal granular hyperfluorescence on FA.

Ultra-Wide-Field Fundus Autofluorescence in Multiple Evanescent White Dot Syndrome

To observe the progression of affected lesions using ultra-wide-field fundus autofluorescence (FAF) in multiple evanescent white dot syndrome. Retrospective, observational case series. setting: Institutional. 14 eyes of 13 patients (mean age, 35.8 years) with acute disease unilaterally. Patients underwent ultra-wide-field FAF, spectral-domain optical coherence tomography (SD OCT), multifocal electroretinography (mfERG), and Goldmann or automated perimetry; the best-corrected visual acuity (BCVA) and refractive error were measured. Ability of ultra-wide-field FAF to detect lesions with greater sensitivity compared with color fundus photography. Ultra-wide-field FAF imaging enabled improved visualization of the affected lesions and showed that the core lesion was in the posterior fundus involving the peripapillary retina and posterior pole and surrounded by hyper-autofluorescent spots outside the vascular arcade. The posterior lesions expanded rapidly and peripheral spots spread farther peripherally and reached a maximal extent during the acute stage. During follow-up, the peripheral hyper-autofluorescent spots resolved and then hyper-autofluorescence of the posterior fundus gradually faded. SD OCT showed diffuse disruption of the photoreceptor inner segment/outer segment junction (IS/OS) in the posterior fundus during the acute stage. The correlation between the IS/OS abnormality and hyper-autofluorescent areas was unclear. The disrupted IS/OS was restored with normalization of the FAF. Ultra-wide-field FAF showed that the lesions arise from the peripapillary retina and the posterior pole and spread peripherally in a centrifugal manner during the acute stage. The hyper-autofluorescent spots faded from the periphery in a centripetal manner.

Multiple Evanescent White-Dot Syndrome in a 14-Year-Old Girl

Purpose: To report a case of multiple evanescent white-dot syndrome (MEWDS) in a 14-year-old female. Case summary: A 14-year-old female presented with decreased visual acuity. Review of systems was unremarkable except for a recent upper respiratory infection prior to her symptoms. On examination, her visual acuity was 20/20 in the right eye and 20/200 in the left eye. Relative afferent pupillary defect was observed. Examination of the left fundus revealed optic disc edema and multiple white dots in the posterior pole. Humphrey visual field test showed enlargement of the blind spot in the left eye. Fluorescein angiography revealed hyperfluorescence and late leakage of the white dots. Indocyanine green angiography showed enlarged late hypofluorescence of the white dots. MEWDS was diagnosed and the patient was followed up with serial examinations. At a follow-up examination 2 weeks later, visual acuity in the left eye improved to 20/70. The majority of white dots on fundus had disappeared and the enlarged scotoma in the left eye recovered to normal size on Humphrey visual field test. At a follow-up examination 3 months later, visual acuity in the left eye improved to 20/30 and residual white dots had further disappeared. Conclusions: Cases of MEWDS have been reported in patients as old as 67 years; however, MEWDS is a rare disease and most patients are young females. The authors describe the youngest case to date in Korea of MEWDS in 14-year-old female with typical clinical course. J Korean Ophthalmol Soc 2015;56(8):1289-1293

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

To characterize multiple evanescent white dot syndrome (MEWDS)-like lesions as diagnosed by clinical exam and fluorescein angiography (FA) to build an epidemiological profile of this disease and highlight the most common angiographical aspects. It is important to emphasize the existence of this syndrome and improve patients' information about the natural good course of this disease. A cross-sectional study including all FA performed from July 2006 to October 2012 (6,111 exams analyzed) in patients at our ophthalmic emergency department, with analysis of the different angiographic aspects of the MEWDS-diagnosed cases. 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. 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.

The Fundus Autofluorescence Spectrum of Punctate Inner Choroidopathy.

Purpose. To investigate the fundus autofluorescence (FAF) spectrum of punctate inner choroidopathy (PIC). Methods. This is a retrospective observational case series of 27 consecutive patients with PIC admitted from October 2013 to March 2015, who underwent short-wavelength- (SW-) and near-infrared- (NIR-) FAF imaging, spectral domain optical coherence tomography (SD-OCT), fluorescein angiography (FA), and indocyanine green angiography (ICGA). Results. There were three primary findings on the FAF imaging of patients with PIC. First, active PIC lesions revealed hypoautofluorescent spots with hyperautofluorescent margin. After the lesions regressed, the hyperautoflurescent margin faded. Second, subclinical and most of the atrophic PIC lesions appeared to be hypoautofluorescent spots. But subclinical PIC lesions were more distinctive on NIR-FAF imaging than on SW-FAF imaging. Third, hypoautofluorescent spots of PIC lesions coexisted with hyperautofluorescent patches on SW-FAF imaging. These hyperautofluorescent patches were demonstrated to be multiple evanescent white dot syndrome (MEWDS) or acute zonal occult outer retinopathy (AZOOR) lesions by subsequent multimodal imaging and faded during follow-up examinations. Conclusion. FAF imaging helps in noninvasively tracking the evolution of PIC lesions and identifying the combined MEWDS or AZOOR lesions, complementary to SD-OCT and angiographic studies.

Epidemiology and Prevalence of Posterior Uveitis in Shimla Hills.

AIM To study the Epidemiology and Prevalence of Posterior Uveitis in Shimla Hills. MATERIAL AND METHODS It is a retro/prospective study of patients with retinal diseases attending the general ophthalmology clinic of a tertiary care facility at Shimla from August 2008 to April 2013.Out of 5600 subjects,4323 were taken as a sample. The data was taken from the hospital records and thereafter analyzed to determine their age, sex distribution and diagnosis. All patients underwent visual acuity, refraction, slit lamp examination and fundus evaluation.The diagnosis was confirmed from fundus clinic records and evaluation of fundus photographic records retro-prospectively.The photographs were taken on the fundus camera (KOWA’S FUNDUS CAMERA VX-10) and fundus fluorescein angoigraphy(FFA) done where ever indicated. RESULTS Amongst the 196 (4.54%) subject of Posterior Uveitis,Toxoplasmosis (TOXO-1.48%) was the most common while Acute Multifocal Placoid Pigment Epitheliopathy(AMPPE-0.02%) and Multiple Evanescent White Dot Syndrome ( MEWDS-0.02%) were the least common disease. CONCLUSION Retinal disorders appear to be a major public health problem in India.The present study shall help us in planning the management of such disorders in the hilly state of Himachal Pradesh to reduce the visual morbidity arising out of such disorders.

Atipik Başlangıçlı Multipl Geçici Beyaz Nokta Sendromu

Atipik Başlangıçlı Multipl Geçici Beyaz Nokta Sendromu

Decreased choroidal blood flow velocity in the pathogenesis of multiple evanescent white dot syndrome.

On the basis of angiographic features, it is suggested that choroidal circulation disturbance may be involved in the pathogenesis of multiple evanescent white dot syndrome (MEWDS). The aim of this study is to quantitatively evaluate changes in choroidal circulation hemodynamics using laser speckle flowgraphy (LSFG) in patients with MEWDS. Twelve eyes of 12 patients with MEWDS and 12 unaffected fellow eyes as controls were included. The macular mean blur rate (MBR), a quantitative index of relative blood flow velocity in the choroid, was measured by LSFG. Sequential changes in the average MBR values at the macula with granular changes and the lesion area with white dots were analysed. Moreover, correlations between the MRR changing rate and initial visual functions were examined. Visual functions significantly improved 3 months after initial visit with accompanying improvements in outer retinal morphology. When compared with the baseline measurements, the MBR significantly increased at the macula of the affected eyes by 20.2 % and 13.0 % at 1 and 3 months respectively (P < 0.01 for both), while no significant change was detected in fellow eyes. Similarly, the MBR increased at the lesion area by 17.8 % and 12.0 % at 1 and 3 months respectively (P < 0.05 for both). Notably, the macular MBR elevation at 1 month was negatively correlated with both initial best-corrected visual acuity and the average threshold at the macula on Humphrey perimetry at baseline (R = -0.76, P = 0.003; R = -0.60, P = 0.03, respectively), suggesting a close link between initially reduced choroidal blood flow and functional abnormalities at the onset of MEWDS. These results, in concert with angiographic findings, are likely to reinforce the concept of choroidal circulation impairment as a predisposing factor for MEWDS.

Contribution of "en face" SD‐OCT in inflammatory diseases

AbstractTo evaluate the retinal and choroidal changes in White Dot syndromes (WDS) using ‘’en face’’ and B‐scan OCT images. All the study patients underwent a comprehensive ophthalmologic examination including biomicroscopic fundus examination, color photography, fundus autofluorescence, fluorescein angiography, indocyanin green angiography and B scan and "en face" SD‐OCT. A total of 10 patients with Multiple evanescent white dot syndrome (MEWDS), 4 cases diagnosed with acute posterior multifocal placoid pigment epitheliopathy (AMPPE), 1 case of serpiginous choroidopathy, 4 cases of multifocal choroiditis, 3 cases of punctuate inner choroidopathy (PIC) and 3 cases diagnosed with Birdshot disease were analysed and included in the study. The B‐scan findings were correlated with the angiography findings as well as with the ‘’en face’’ OCT scans. In all the cases the ‘’en face’’ OCT, providing a layer‐by‐layer view of the involved retina, enabled depicting in detail the IS/OS envolvement and the extent of the outer retinal damage. The patho‐physiologic mechanism of the WDS remains poorly understood. All these entities probably share a common pathway leading to external retinal involvem