1. Multiple evanescent white dot syndrome
Rim Kahloun
Sonia Attia
Samah Mbarek
Riadh Messaoud
Department of ophthalmology
Fattouma Bourguiba University Hospital
Faculty of Medicine,University of Monastir
Monastir, Tunisia

2. History
24-year-old woman
Medical and ocular history: unremarkable
Blurred vision and scotoma in the left eye (OS) since a few days

3. No anterior chamber cells or flare No Vitreous cells or flare
First Presentation
Visual acuity: 20/20 OD, 20/32 OS
No anterior chamber cells or flare
No Vitreous cells or flare
Intraocular pressure: 12 mmHg OU

4. Fundus examination shows normal findings OD and multiple deep yellow-white dots with foveal granularity OS.

5. Visual field testing
Visual field testing shows enlargement of the blind spot OS.

6. Fluorescein angiography
early hyperfluorescence and
late staining of the white dots

7. Indocyanine green angiography
Late-phase multiple hypofluorescent lesions with peripapillary area of hypofluorescence.

8. Optical coherence tomography
disruption of the outer retinal layers

9. Electroretinography (ERG)
Scotopic ERG: decrease in a-wave amplitudes and latences and a decrease in b-wave amplitude with normal latences.
Photopic ERG: decrease in b-wave amplitude with normal latences OS

10. Multiple evanescent white dot syndrome (MEWDS)
Final diagnosis
Multiple evanescent white dot syndrome (MEWDS)

11. Management
No specific treatment
Observation

12. Follow-up Resolution of retinal white dots
Regression of macular granularity, leaving subtle retinal pigment epithelial changes
Visual acuity recovery within 8 weeks.

13. Conclusion
MEWDS is a rare disorder of the choroid and RPE that should be considered in differential diagnosis of acute unilateral visual loss in young, healthy patients
The diagnosis of MEWDS can usually be made on the basis of typical clinical features. A multimodal diagnostic approach including FA, ICGA, SD-OCT, fundus autofluorescence, visual field testing, and ERG may help establish the definitive diagnosis and differentiate MEWDS from other entities that present with white dots.
The visual prognosis of MEWDS is often excellent.