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Multiple evanescent white dot syndrome.

Nicole E Gross1, Lawrence A Yannuzzi, K Bailey Freund

  • 1LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, NY 10021, USA.

Archives of Ophthalmology (Chicago, Ill. : 1960)
|April 12, 2006
PubMed
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Multiple Evanescent White Dot Syndrome (MEWDS) can present with a new dual-layered lesion variant. This chorioretinopathy shows distinct angiographic features, suggesting varied retinal and choroidal involvement.

Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Retinal Diseases

Background:

  • Multiple Evanescent White Dot Syndrome (MEWDS) is an idiopathic inflammatory condition affecting the outer retina and retinal pigment epithelium.
  • Understanding the full spectrum of MEWDS clinical and angiographic presentations is crucial for accurate diagnosis and management.

Purpose of the Study:

  • To investigate the clinical and angiographic characteristics of MEWDS lesions.
  • To identify and describe a novel clinical variation of MEWDS.
  • To elucidate the pathophysiological basis of MEWDS through detailed imaging analysis.

Main Methods:

  • Case series of five patients diagnosed with MEWDS based on characteristic angiographic findings.
  • Comprehensive ophthalmic examination including slitlamp biomicroscopy.

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  • Advanced imaging techniques: Fluorescein angiography (FA) and Indocyanine Green angiography (ICGA).

    • Main Results:

    • A newly recognized angiographic pattern termed 'dots and spots' was observed in all patients.
    • Lesions varied in size and depth, with small dots in the inner retina/RPE and larger spots in the sub-RPE space.
    • Typical MEWDS features like visual field loss and foveal granularity were also present.

    Conclusions:

    • A distinct clinical variant of MEWDS featuring dual-layered lesions was identified.
    • Late-phase ICGA revealed specific findings of small hypofluorescent lesions overlying larger ones.
    • MEWDS appears to be a chorioretinopathy with variable retinal and choroidal involvement.