Introduction
The White Dot Syndromes are a set of conditions with hypo-pigmented inflammatory lesions in the choroid, RPE, outer retina (OPL, ONL, ELM, PR, RPE) and/or choriocapillaris.
It's common symptoms (5 WDS symptoms) include:
- Blurred vision
- VF loss
- Photopsia
- Floaters
- Scotomas
MEWDS is typically found in healthy myopic females around 20-50 y/o.
- Unilateral
- 50% present with flu like illness preceding the ocular symptoms
- Lesions first arise in the posterior pole, spreading out to the periphery during the acute phase
- Over time, lesions fade first in the periphery and eventually also fading in the posterior pole
Dead Giveaways
Symptoms:
Compared to the other white dot syndromes, MEWDS has the specific symptom of dyschromatopsia
Fundus Appearance:
The fundus appearance is characterised by presence of white dots
FAF also shows the presence of multiple white dots
OCT Appearance:
Characterised by slight disturbances in the EZ in the parafoveal regions
Additionally, buildup of hyper-reflective material may be seen in the ellipsoid zone and ONL
In the left, hyper-reflective build up seen, and throughout, EZ breakage can be visualised
diagnostic features
Prognosis:
Typically self-resolving after weeks to months
Recurrences are possible
White dots typically regress, but atrophy of photoreceptors may occur
Resolved MEWDS FAF