MEWDSMEWDSMultiple Evanescent White Dot

Syndrome

General Hospital Pula Croatia

Department of Opthtalmology

Edi Ladavac

Clinical features

• Strong female predominance

• Young adults

• One eye

• Blurred vision and fotopsia

• Average duration of 6 weaks

• Good recovery of visual function

Clinical picture

• Multiple white dots at the level of the deep retina or RPE

• Blurring of the disk margins• Granular orange or yelow dots in the

macula

Case 1 – clinical picture

Visus : 0,5

Ancillary testing

• FAG

• ICG angiography

• Visual field

• ERG

Fluorescein angiography

• Early and late hyperfluorescence of the white dots

• Diffuse (patchy) late staining at the level of RPE

• Disk capillary leakege

Case 1 - FAG

MEWDS

normal eye

Case 2

Visus : 0,6

Case 2 - FAG

FAG 1

FAG 2

FAG 3

Case 2 - FAG

MEWDS

normal eye

Visual field

Enlarged blinde spot

ICG angiography

demonstrate a greaternumber of lesions than are seen with ophthalmoscopy or FAG Yannuzzi

Differential diagnosiswhite dots syndroms

• Multifocal choroiditis• APMPPE• Acute idiopathic blind spot enlargement

sy• Punctate inner choroidopathy• Acute macular neuroretinopathy• Acute zonal occult outer retinopathy

Multifocal choroiditis

APMPPE

Conclusion

The disease usually has a self-limited course with good visual recovery. Approximately 90% of patients have better than 20/30 final visual acuity. There is a return of normal funduscopic appearance, although macular changes may persist. Because of its self-limited course, no treatment for MEWDS currently is indicated.

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