MEWDS Multiple 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 normal eye MEWDS

Case 2 Visus : 0,6

Case 2 - FAG FAG 2 FAG 1 FAG 3

Case 2 - FAG normal eye MEWDS

Visual field Enlarged blinde spot

ICG angiography demonstrate a greater number of lesions than are seen with ophthalmoscopy or FAG Yannuzzi

Differential diagnosis white 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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