Multiple evanescent white dot syndromes

PURPOSE The aim of this study is to report a patient with multipe evanescent white dot syndrome (MEWDS) presenting with classic foveal granularity and pathology localized to the outer retina. METHODS Case study methodology was used in the current study. RESULTS A 34-year-old Caucasian female presented with photopsias and blurry vision in her left eye. Examination, particularly the foveal granularity noted in her affected eye, was archetypal for the diagnosis of MEWDS. Fundus autofluorescence, fluorescein and indocyanine green angiography were also consistent with this diagnosis. Spectral-domain optical coherence tomography (SD-OCT) demonstrated increased retinal pigment epithelium granularity and disruption of the photoreceptor inner segment-outer segment junction subfoveally. CONCLUSIONS Foveal granularity may be the most specific feature of MEWDS with SD-OCT capable of localizing pathology to the outer retina-a historically controversial finding.