This healthy 27YO female presented with 2 weeks of photopsias OS. Vision was 20/20 in her normal OD and 20/25 OS.
Color photography shows multiple faint subretinal white dots scattered throughout the posterior pole. The nerve is slightly edematous, and the fovea has a granular appearance. OCT scanning shows scattered focal areas of ellipsoid zone and outer retinal band loss. Visual field testing shows an enlarged blind spot OS.
Learning Points:
Multiple evanescent white dot syndrome (MEWDS) is a usually unilateral, idiopathic inflammation of the outer retina that typically occurs in young, healthy myopic females. The granular fovea (Jampol spots, named in honor of Dr. Lee Jampol, who first described this syndrome in 1984) is a classic pathognomonic finding. Acutely, patients will also have an enlarged blind spot, often complaining of temporal visual field loss, due to the 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 two disorders were the same disease but with distinct findings at different points in time.
