This 35YO male presented with 1 week of bilateral vision loss. Vision was 20/30 OD and 20/60 OS. Optos color imaging shows multiple deep retinal white dots scattered throughout the posterior pole (left eye only). Fundus autofluorescence (FAF) more dramatically shows these hyper-FAF lesions.
Three weeks later, vision improved to 20/30 OD and 20/25 OS as the lesions started to regress.
Learning Points:
Multiple evanescent white dot syndrome (MEWDS) presents with usually unilateral idiopathic inflammation of the outer retina that typically occurs in young, healthy myopic females.
The granular fovea (Jampol spots, named after Dr. Lee Jampol, who first described this syndrome in 1984) is a classic pathognomonic finding.
Acute cases will also have an enlarged blind spot, often with temporal visual field loss, due to peripapillary inflammation.
The white dots disappear within a week or two, which is why the lesions are called “evanescent”. However, the blind spot may persist for many months, well after the fundus appearance has normalized.
This stage of MEWDS was originally called the Acute Idiopathic Blind Spot Enlargement (AIBSE) syndrome before Gass recognized that the 2 disorders were the same disease but with distinct findings at different points in time.
