International Ophthalmology

, Volume 38, Issue 5, pp 2153–2158 | Cite as

Bilateral multiple evanescent white dot syndrome

  • Chiara VeroneseEmail author
  • Chiara Maiolo
  • Mariachiara Morara
  • Grayson W. Armstrong
  • Antonio P. Ciardella
Photo Essay



To present a single case of bilateral multiple evanescent white dot syndrome (MEWDS).


A single case with three months of follow-up using imaging studies including fundus color photography (FP), fluorescein angiography (FA), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), spectral-domain optical coherence tomography (SD-OCT), en face SD-OCT and optical coherence tomography angiography (OCTA) is presented.


The patient presented with bilateral MEWDS, ultimately with complete resolution of symptoms. FP revealed foveal granularity and white punctate deep retinal spots, FA found early wreath-like hyperfluorescence, while ICGA showed hypofluorescent dots and spots in the early and late stages. FAF showed areas of hyperautofluorescence. SD-OCT revealed disruption of the ellipsoid zone (EZ) and accumulation of hyperreflective material of variable size and shape. En face SD-OCT demonstrated hyporeflective areas corresponding to areas of EZ disruption as well as hyperreflective dots in the outer nuclear layer. OCTA showed areas of photoreceptor slab black-out corresponding to areas of EZ disruption and light areas of flow void or flow disturbance in the choriocapillaris slab.


This case represents an unusual case of bilateral MEWDS with complete resolution within three months.


Bilateral multiple evanescent white dot syndrome En face SD-OCT Fundus autofluorescence OCTA 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Chiara Veronese
    • 1
    Email author
  • Chiara Maiolo
    • 2
  • Mariachiara Morara
    • 1
  • Grayson W. Armstrong
    • 3
  • Antonio P. Ciardella
    • 1
  1. 1.Ophthalmology Unit, S. Orsola-Malpighi HospitalUniversity of BolognaBolognaItaly
  2. 2.University of BolognaBolognaItaly
  3. 3.Ophthalmology DepartmentMassachusetts Eye and Ear Infirmary/Harvard Medical SchoolBostonUSA

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