Clinical Study ‘‘En-Face’’ Spectral-Domain Optical Coherence Tomography Findings in Multiple Evanescent White Dot Syndrome Flore De bats, 1 Benjamin Wolff, 2,3 Vivien Vasseur, 2 Aude Affortit, 2 Laurent Kodjikian, 1 José-Alain Sahel, 2 and Martine Mauget-faÿsse 2,3,4 1 Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Medicine Lyon 1, 103 Grande rue de la Croix Rousse, 69317 Lyon Cedex 04, France 2 Professor Sahel Department, Rothschild Ophthalmologic Foundation, 25 rue Manin, 75019 Paris, France 3 Kleber Retinal Center, 50 Cours Franklin Roosevelt, 69006 Lyon, France 4 Monticelli Paradis Retinal Center, 88 rue du Commandant Rolland, 13008 Marseille, France Correspondence should be addressed to Benjamin Wolf; bwolf@hotmail.fr Received 12 August 2013; Revised 17 February 2014; Accepted 19 February 2014; Published 22 April 2014 Academic Editor: Hermann Mucke Copyright © 2014 Flore De bats et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. he recent use of “en-face” enhanced-depth imaging spectral-domain optical coherence tomography (EDI SD-OCT) helps distinguish the retinal layers involved in the physiopathology of multiple evanescent white dot syndrome (MEWDS). Methods. Four patients presenting with MEWDS underwent a comprehensive ocular examination including C-scan (“en-face”) EDI SD-OCT at the initial visit and during follow-up. Results. C-scans combined with the other multimodal imaging enabled the visualization of retinal damage. Acute lesions appeared as difuse and focal disruptions occurring in the ellipsoid and interdigitation zones. he match between autoluorescence imaging, indocyanine green angiography, and “en-face” OCT helped identify the acute microstructural damages in the outer retina further than the choroid. Follow-up using “en-face” EDI-OCT revealed progressive and complete recovery of the central outer retinal layers. Conclusion. “En-face” EDI SD-OCT identiied the site of initial damage in MEWDS as the photoreceptors and the interdigitation layers rather than the choroid. Moreover, “en-face” OCT is helpful in the follow-up of these lesions by being able to show the recovery of the outer retinal layers. 1. Introduction Multiple evanescent white dot syndrome (MEWDS) typically afects young females and presents as a sudden visual loss with paracentral scotomas. hese symptoms usually occur follow- ing an inluenza-like illness, but the pathophysiologic mecha- nism is still poorly understood. In 80% of cases, the condition remains unilateral. Fundus examination reveals small, tiny perifoveal yellow-white dots, foveal granularity, and, in some cases, very mild vitritis, vasculitis, venous dilations, and papillitis. In addition to these clinical parameters, multi- modal imaging including autoluorescence imaging, luo- rescein (FA) and indocyanine green angiographies (ICGA), and B-scan enhanced-depth imaging spectral-domain optical coherence tomography (EDI SD-OCT) help conirm the diagnosis. It has been suggested that the initial lesion is located in the choroid due to the numerous hypoluorescent lesions observed in the late phase of ICG. he recent use of “en-face” OCT for MEWDS, which allows a layer-by-layer view of the involved retina, adds new information in the evaluation of the associated physiopathological process [1]. In this study, the C-scan or “en-face” EDI SD-OCT scans of patients presenting with MEWDS were combined with data from classical retinal imaging, namely, fundus color photography, autoluorescence imaging, angiographies, and B-scan EDI SD-OCT in order to show the initial site of damage in MEWDS. 2. Method Patients presenting with MEWDS underwent a comprehen- sive ocular examination with the best-corrected visual acuity Hindawi Publishing Corporation Journal of Ophthalmology Volume 2014, Article ID 928028, 6 pages http://dx.doi.org/10.1155/2014/928028