Multiple evanescent white dot syndrome: multimodal imaging and correlation with proposed pathophysiology

The clinical presentation of multiple evanescent white dot syndrome (MEWDS) was described nearly 30 years ago; however, our understanding of its pathophysiology continues to change, evolving with our imaging modalities. Initially, electroretinography and fluorescein angiography indicated retinal pigment epithelium (RPE) and outer retinal damage. But with indocyanine green angiography, theories shifted to a primary choroidopathy. Only spectral-domain optical coherence tomography (SD-OCT) directly demonstrated the primary effect on RPE and outer retina, although enhanced depth-imaging OCT (EDI-OCT) may further modify our understanding. The authors present a case of unilateral MEWDS with imaging including SD-OCT and EDI-OCT.