UMDNJ-NJMS Ophthalmology: Case of the Month

UNIVERSITY OPHTHALMOLOGY CONSULTANTS

CASE OF THE MONTH

CASE #25

OCULAR TRAUMA

MULTIPLE EVANESCENT WHITE DOT SYNDROME (MEWDS)

	First described in 1984 by Jampol et al, MEWDS is an entity of unknown etiology that affects mainly young women with sudden onset of unilateral vision loss (although bilateral cases have been reported) (1-5).
	There may be a history of antecedent influenza-like symptoms in as many as half the patients.
	Vision loss is often associated with photopsia and an enlarged blind spot, the latter often unrecognized by the patient.
	On fundus exam, patients in the acute phase present with white multifocal ill-defined gray-white lesions at the level of the RPE or the deep retina (2, 6, 7). These lesions are most frequently seen in the peripheral macular and juxtapapillary areas.
	The central macular area often is spared even in patients with loss of central vision. These latter patients may develop multiple punctate orange deposits under the foveolar area.
	In addition to these findings, mild vitritis, blurring of the disc margin, and perivascular sheathing have been described (2, 6, 7).

REFERENCES
	1. Aaberg TM, Campo RV, Joffe L. Recurrences and bilaterality in the multiple evanescent white dot syndrome. Am J Ophthalmol 1985;100:29-37.
	2. Jampol LM, Sieving PA, Pugh D, et al. Multiple evanescent white dot syndrome. I. Clinical findings. Arch Ophthalmol 1984;102:671-4.
	3. Jost BF, Olk RJ, McGaughey A. Bilateral symptomatic multiple evanescent white dot syndrome. Am J Ophthalmol 1986;101:489-90.
	4. Meyer RJ, Jampol LM. Recurrences and bilaterality in the multiple evanescent white dot syndrome. Am J Ophthalmol 1986;101:388-9.
	5. Tsai L, Jampol LM, Pollack SC. Chronic recurrent multiple evanescent white dot syndrome. Retina 1994;14:160-3.
	6. Gass JD. Stereoscopic atlas of macular diseases. Diagnosis and treatment. 4th ed. Mosby; 1997.
	7. Leys A, Leys M, Jonckheere P, et al. Multiple evanescent white dot syndrome (MEWDS). Bull Soc Belge Ophthalmol 1990;236:97-108.


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