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An Elderly Man with Atypical Multiple Evanescent White Dot Syndrome
Liang Wang1, Polina Lankry2, David Rabinovitch2
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
Case Reports in Ophthalmology
|December 5, 2022
Summary
A rare atypical case of Multiple Evanescent White Dot Syndrome (MEWDS) occurred in an elderly man, presenting with severe vision loss that resolved spontaneously. Multimodal imaging confirmed classic MEWDS findings despite the atypical presentation.
Area of Science:
- Ophthalmology
- Medical Imaging
- Retinal Diseases
Background:
- Multiple Evanescent White Dot Syndrome (MEWDS) is an idiopathic inflammatory condition typically affecting young adults.
- Atypical presentations of MEWDS are uncommon, especially in elderly individuals without preceding viral prodrome or characteristic fundus findings.
Observation:
- A 75-year-old male presented with acute, severe unilateral vision loss.
- The patient lacked a viral prodrome and initial funduscopic examination did not reveal the typical white dots associated with MEWDS.
- Visual acuity spontaneously returned to baseline within several weeks without any intervention.
Findings:
- Multimodal imaging, including fluorescein angiography (FA), fundus autofluorescence (FAF), indocyanine green angiography (ICG), and optical coherence tomography (OCT), revealed classic signs of MEWDS.
- Wreath-like lesions and inflammatory foci within the retinal pigment epithelium were consistently observed across all imaging modalities.
- Systemic workup excluded underlying systemic disorders that could explain the ocular findings.
Implications:
- This case highlights the possibility of atypical MEWDS presentation in the elderly population.
- The study demonstrates the crucial role of multimodal imaging in diagnosing MEWDS, even in non-classic scenarios.
- This report expands the known clinical spectrum of MEWDS and its diagnostic imaging features.
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