Transcript MEWDS Multiple Evanescent White Dot Syndrome

MEWDS
Multiple Evanescent White Dot
Syndrome
General Hospital Pula
Department of Opthtalmology
Edi Ladavac
Croatia
Clinical features
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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
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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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