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MEWDS Multiple Evanescent White Dot Syndrome. General Hospital Pula Croatia Department of Opthtalmology Edi Ladavac. Clinical features. Strong female predominance Young adults One eye Blurred vision and fotopsia Average duration of 6 weaks Good recovery of visual function.
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MEWDSMultiple Evanescent White Dot Syndrome General Hospital Pula Croatia Department of Opthtalmology Edi Ladavac
Clinical features • Strong female predominance • Young adults • One eye • Blurred vision and fotopsia • Average duration of 6 weaks • Good recovery of visual function
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
Case 1 – clinical picture Visus : 0,5
Ancillary testing • FAG • ICG angiography • Visual field • ERG
Fluorescein angiography • Early and late hyperfluorescence of the white dots • Diffuse (patchy) late staining at the level of RPE • Disk capillary leakege
Case 1 - FAG normal eye MEWDS
Case 2 Visus : 0,6
Case 2 - FAG FAG 2 FAG 1 FAG 3
Case 2 - FAG normal eye MEWDS
Visual field Enlarged blinde spot
ICG angiography demonstrate a greater number of lesions than are seen with ophthalmoscopy or FAG Yannuzzi
Differential diagnosiswhite dots syndroms • Multifocal choroiditis • APMPPE • Acute idiopathic blind spot enlargement sy • Punctate inner choroidopathy • Acute macular neuroretinopathy • Acute zonal occult outer retinopathy
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.