mewds mewds multiple evanescent white dot syndrome general hospital pula croatia department of...
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MEWDSMEWDSMultiple 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
MEWDS
normal eye
Case 2
Visus : 0,6
Case 2 - FAG
FAG 1
FAG 2
FAG 3
Case 2 - FAG
MEWDS
normal eye
Visual field
Enlarged blinde spot
ICG angiography
demonstrate a greaternumber 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
Multifocal choroiditis
APMPPE
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.
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