Swept-Source optical coherence tomography angiography shows choriocapillaris flow reduction in multiple evanescent white dot syndrome

Purpose: To report two cases of typical multiple evanescent white dot syndrome (MEWDS), in which swept-source optical coherence tomography angiography (SS-OCTA) revealed transient areas of flow deficit at the level of the choriocapillaris. Methods: The SS-OCTA images of two female patients with typical MEWDS were analyzed at the onset of the disease and during follow-up. Results: The patients were aged 24 and 25 years, respectively. Previous medical history was unremarkable in both cases. The diagnosis of MEWDS was made on the basis of typical clinical findings and results of fundus autofluorescence, fluorescein angiography, and optical coherence tomography. At presentation, SS-OCTA showed a few small hypointense areas of flow deficit at the level of the choriocapillaris in both cases. During follow-up, SS-OCTA showed complete resolution of choriocapillaris flow voids. Conclusion: Both our patients with typical acute MEWDS showed SS-OCTA multifocal small areas of flow reduction at the level of the choriocapillaris, with full recovery during the follow-up. This finding supports the hypothesis of transient, primary, or secondary choriocapillaris hypoperfusion in typical MEWDS.