multiple evanescent white dot syndrome
A condition primarily affecting young, myopic women, age 14-47; female:male, 5:1; up to 50% of patients report a prodromal viral illness
Clinical findings Acute unilateral or markedly u in the temporal field, often emanating from the blind spot; shimmering photopsias are common and located within scotomas
Aetiology Potential infectious
Diagnosis Fluorescein angiography–early punctate hyperfluorescence and late staining corresponding to the white dots
Fundoscopy Numerous 100 to 300 µm gray-white flat dots, located just outside the macula in the midperiphery. Foveal granularity–i.e., presence of numerous white or yellow specks within 250 µm of the foveola, commonly seen and is a virtually pathognomonic feature of MEWDS
Prognosis Spontaneous recovery of vision usually occurs over 3-10 weeks with disappearance of the white dots; foveal granularity usually takes longer to resolve and may be replaced by pigment mottling; patients may exhibit persistent blind spot enlargement; because of its favorable natural history, no treatment is indicated for typical cases; laser photocoagulation may be necessary.
Synonyms Acute disseminated retinal pigment epitheliopathy, MEWDS