Multiple evanescent white dot syndrome

Multiple evanescent white dot syndrome (MEWDS) is an uncommon inflammatory condition of the retina that typically affects otherwise healthy young females in the second to fourth decades of life.

The typical patient with MEWDS is a healthy middle aged female age 15-50. There is a gender disparity as women are affected with MEWDS four times more often than men. Roughly 30% of patients have experienced an associated viral prodrome. Patients present with acute, painless, unilateral change in vision. [1]

Presentation

Patients present with acute unilateral decreased vision, photopsias and central or paracentral scotoma. An antecedent viral prodrome occurs in approximately one-third of cases. Myopia is commonly seen in patients.

Eye exam during the acute phase of the disease reveals multiple discrete white to orange spots at the level of the RPE or deep retina, typically in a perifoveal location (around the fovea).

Cause

Diagnosis
  • Visual field abnormalities are variable and include generalized depression of visual field, paracentral or peripheral scotoma and enlargement of the blind spot.
  • Fluorescein angiography of the eye reveals characteristic punctate hyperfluorescent lesions in a wreath-like configuration surrounding the fovea.
  • Indocyanine green angiography reveals hypofluorescent lesions in a greater number compared with other studies.
  • Fundus autofluorescence (FAF) has been shown to be a noninvasive method to demonstrate the subretinal spots in MEWDS.

Treatment

MEWDS is a self limited disease with excellent visual recovery within 2-10 weeks. However residual symptoms including photopsia may persist for months.

References
  1. Brian Toussaint MD (December 6, 2014). [Multiple_Evanescent_White_Dot_Syndrome "Multiple Evanescent White Dot Syndrome"] Check |url= value (help). EyeWiki.
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