MEWDS Multiple Evanescent White Dot Syndrome

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MEWDSMultiple Evanescent White Dot Syndrome

• General Hospital Pula Croatia
• Department of Opthtalmology
• Edi Ladavac

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Clinical features

• Strong female predominance
• Young adults
• One eye
• Blurred vision and fotopsia
• Average duration of 6 weaks
• Good recovery of visual function

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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

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Case 1 clinical picture
Visus 0,5
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Ancillary testing

• FAG
• ICG angiography
• Visual field
• ERG

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Fluorescein angiography

• Early and late hyperfluorescence of the white
  dots
• Diffuse (patchy) late staining at the level of
  RPE
• Disk capillary leakege

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Case 1 - FAG
normal eye
MEWDS
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Case 2
Visus 0,6
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Case 2 - FAG
FAG 2
FAG 1
FAG 3
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Case 2 - FAG
normal eye
MEWDS
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Visual field
Enlarged blinde spot
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ICG angiography
demonstrate a greater number of lesions than are
seen with ophthalmoscopy or FAG
Yannuzzi
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Differential diagnosiswhite dots syndroms

• Multifocal choroiditis
• APMPPE
• Acute idiopathic blind spot enlargement sy
• Punctate inner choroidopathy
• Acute macular neuroretinopathy
• Acute zonal occult outer retinopathy

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Multifocal choroiditis
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APMPPE
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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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Thank You