1. MEWDS Multiple Evanescent White Dot Syndrome
General Hospital Pula Croatia
Department of Opthtalmology
Edi Ladavac

2. Clinical features Strong female predominance Young adults One eye
Blurred vision and fotopsia
Average duration of 6 weaks
Good recovery of visual function

3. Clinical picture
Multiple white dots at the level of the deep retina or RPE
Blurring of the disk margins
Granular orange or yelow dots in the macula

4. Case 1 – clinical picture
Visus : 0,5

5. Ancillary testing
FAG
ICG angiography
Visual field
ERG

6. Fluorescein angiography
Early and late hyperfluorescence of the white dots
Diffuse (patchy) late staining at the level of RPE
Disk capillary leakege

7. Case 1 - FAG
normal eye
MEWDS

8. Case 2
Visus : 0,6

9. Case 2 - FAG
FAG 2
FAG 1
FAG 3

10. Case 2 - FAG
normal eye
MEWDS

11. Visual field
Enlarged blinde spot

12. ICG angiography demonstrate a greater
number of lesions than are seen with ophthalmoscopy or FAG
Yannuzzi

13. Differential diagnosis white dots syndroms
Multifocal choroiditis
APMPPE
Acute idiopathic blind spot enlargement sy
Punctate inner choroidopathy
Acute macular neuroretinopathy
Acute zonal occult outer retinopathy

14. Multifocal choroiditis

15. APMPPE

16. Conclusion
The disease usually has a self-limited course with good visual recovery. Approximately 90% of patients have better than 20/30 final visual acuity. There is a return of normal funduscopic appearance, although macular changes may persist.
Because of its self-limited course, no treatment for MEWDS currently is indicated.

17. Thank You