Multiple Evanescent White Dot Syndrome

Multiple evanescent white dot syndrome (MEWDS) is a unilateral, spontaneously resolving condition primarily affecting females between the ages of 20 and 45. It is often preceded by a virus.

Presenting symptoms include a sudden reduction in visual acuity, photopsia, visual scotomas (temporal or paracentral) and dyschromatopsia.

Clinically, multiple white dots may be seen throughout the retina and the fovea typically has a granular appearance. A mild vitritis and hypeaemic disc with or without blurred disc margins may also be noted in some cases.

Fundus autofluorescence imaging shows hyper-fluorescence of the white retinal dots and pinpoint hypo-fluorescence in the area of foveal granularity.

OCT shows disruption of the ellipsoid zone in areas corresponding to the white dots, indicating that the photoreceptors are impacted in this disease.

MEWDS resolves spontaneously over a period of weeks to months with vision and visual fields returning to normal. This condition however may be recurrent, in which case atrophy of the photoreceptors may be noted.

Knickelbein, JE. Nida Sen, H. (2016) Multimodal Imaging of the White Dot Syndromes and Related Diseases J Clin Exp Ophthalmol. 2016 June ; 7(3): .

Wong, E. Nivison-Smith, L. Assaad, NN. Kalloniatis, M. (2015). OCT and fundus autofluorescence enhances visualization of white dot syndromes. Optometry and Vision Science, 92(5):642-53.