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MEWDS Multiple Evanescent White Dot Syndrome

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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MEWDS Multiple Evanescent White Dot Syndrome

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  1. MEWDSMultiple 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 diagnosiswhite 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

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