This 22YO female presented with blurred vision in her left eye for 2 weeks. Vision was 20/20 in her normal right eye and 20/70 in her left eye.
Optos color imaging of her left eye shows multiple faint, deep retinal white dots scattered throughout, which are hyper-autofluorescent. Macular OCT scanning was virtually normal (image not shown).
Two months later, the fundoscopic changes resolved, although fundus autofluorescence and Optos green channel imaging show more subtle residual findings.
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 that was not seen in this patient. 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.
