This 25YO female presented with 20/25 vision OU and a four-day history of temporal field loss in her left eye. Examination of the right eye was normal.
There was a granular appearance to the left fovea with some deep retinal white dots, most visible just nasal to the nerve. Fundus autofluorescence (FAF) more dramatically showed a ring of hyper-FAF encircling the nerve with multiple hyper-FAF spots extending inferiorly.
Learning Points:
Multiple evanescent white dot syndrome (MEWDS) presents with unilateral idiopathic inflammation of the outer retina, typically occurring in young, healthy myopic females.
The granular fovea (Jampol spots, named in honor of Dr. Lee Jampol, who first described this syndrome in 1984) noted in our case 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 Dr. Gass recognized that the 2 disorders were the same disease but with distinct findings at different points in time.
