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Optic disc pit: A trigger for secondary multiple evanescent white dot syndrome.
Shivesh Varma1,2, Royce W S Chen3, Jeffrey M Liebmann3
1Vitreous Retina Macula Consultants of New York, New York, USA.
Retinal Cases & Brief Reports
|April 25, 2025
Summary
Optic disc pit can trigger secondary multiple evanescent white dot syndrome (MEWDS). This condition may present as "spots without dots," distinguishing it from primary MEWDS.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Neuro-ophthalmology
Background:
- Multiple evanescent white dot syndrome (MEWDS) is an idiopathic inflammatory condition affecting the outer retina.
- Secondary forms of MEWDS are increasingly recognized.
- Optic disc anomalies, such as optic disc pits, are rarely implicated as triggers.
Purpose of the Study:
- To report a case of secondary MEWDS triggered by an optic disc pit.
- To investigate the clinical and imaging characteristics of this specific presentation.
- To differentiate this secondary form from primary MEWDS.
Main Methods:
- Observational case report.
- Clinical examination and multimodal imaging (including fundus autofluorescence).
- Serial follow-up over three months.
Main Results:
- A 41-year-old male presented with vision loss and photopsia in the right eye.
- Clinical and imaging findings were consistent with unilateral MEWDS, with the optic disc pit suspected as the trigger.
- Fundus autofluorescence showed transient hyperautofluorescent spots, without the typical hyperautofluorescent dots seen in primary MEWDS.
- Visual acuity improved from 20/100 to 20/25 within three months.
Conclusions:
- Optic disc pits can serve as a trigger for secondary MEWDS.
- The presentation of 'spots without dots' on fundus autofluorescence may be a distinguishing feature of secondary MEWDS.
- This case expands the understanding of potential etiologies for secondary MEWDS.
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