Multiple Evanescent White Dot Syndrome

  • Alessandro Invernizzi
Living reference work entry


Multiple evanescent white dot syndrome (MEWDS) is an inflammatory condition of the eye, unilateral in most of the cases, and generally characterized by a good visual prognosis with no need for treatment. MEWDS derives its name from its appearance at funduscopic examination that typically reveals multiple, yellow-white dots deep in the retina. Although an immune-mediated mechanism in a genetically susceptible person, triggered by a viral systemic infection, has been proposed as cause of MEWDS, Its precise pathogenesis remains unknown. There are no specific blood tests to diagnose MEWDS, however the disease shows peculiar findings on fundus autofluorescence and indocyanine green angiography. Thus, a multimodal imaging study with particular focus on these techniques is helpful in reaching the correct diagnosis avoiding useless treatments.


Fluorescein Angiography Well Correct Visual Acuity Spectral Domain Optical Coherence Tomography Indocyanine Green Angiography Outer Retinal Layer 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Suggested Reading

  1. Abu-Yaghi NE, Hartono SP, Hodge DO, Pulido JS, Bakri SJ. White dot syndromes: a 20-year study of incidence, clinical features, and outcomes. Ocul Immunol Inflamm. 2011;19(6):426–30.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Cimino L, Auer C, Herbort CP. Sensitivity of indocyanine green angiography for the follow-up of active inflammatory choriocapillaropathies. Ocul Immunol Inflamm. 2000;8(4):275–83.CrossRefPubMedGoogle Scholar
  3. Dell’omo R, Wong R, Marino M, Konstantopoulou K, Pavesio C. Relationship between different fluorescein and indocyanine green angiography features in multiple evanescent white dot syndrome. Br J Ophthalmol. 2010;94(1):59–63.CrossRefPubMedGoogle Scholar
  4. Feigl B, Haas A, El-Shabrawi Y. Multifocal ERG in multiple evanescent white dot syndrome. Graefes Arch Clin Exp Ophthalmol. 2002;240(8):615–21. Epub 2002 Jul 6.CrossRefPubMedGoogle Scholar
  5. Giovannini A, Scassellati-Sforzolini B, Mariotti C, D’Altobrando E. Indocyanine green angiographic findings in idiopathic choroidal neovascularization. Int Ophthalmol. 1996–1997;20(4):171–9.Google Scholar
  6. Gross NE, Yannuzzi LA, Freund KB, Spaide RF, Amato GP, Sigal R. Multiple evanescent white dot syndrome. Arch Ophthalmol. 2006;124(4):493–500.CrossRefPubMedGoogle Scholar
  7. Hangai M, Fujimoto M, Yoshimura N. Features and function of multiple evanescent white dot syndrome. Arch Ophthalmol. 2009;127(10):1307–13.CrossRefPubMedGoogle Scholar
  8. Jampol LM, Sieving PA, Pugh D, et al. Multiple evanescent white dot syndrome. I. Clinical findings. Arch Ophthalmol. 1984;102:671–4.CrossRefPubMedGoogle Scholar
  9. Joseph A, Rahimy E, Freund KB, Sorenson JA, Sarraf D. Fundus autofluorescence and photoreceptor bleaching in multiple evanescent white dot syndrome. Ophthalmic Surg Lasers Imag Retina. 2013;44(6):588–92.CrossRefGoogle Scholar
  10. Li D, Kishi S. Restored photoreceptor outer segment damage in multiple evanescent white dot syndrome. Ophthalmology. 2009;116(4):762–70.CrossRefPubMedGoogle Scholar
  11. Löw U, Palmowski AM, Weich CM, Ruprecht KW. [Choroidal neovascularization followed in a patient with “Multiple Evanescent White Dot Syndrome” (MEWDS) – a case report]. Klin Monbl Augenheilkd. 2004;221(12):1051–3.CrossRefPubMedGoogle Scholar
  12. Papadia M, Herbort CP. Idiopathic choroidal neovascularisation as the inaugural sign of multiple evanescent white dot syndrome. Middle East Afr J Ophthalmol. 2010;17(3):270–4.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Rouvas AA, Ladas ID, Papakostas TD, Moschos MM, Vergados I. Intravitreal ranibizumab in a patient with choroidal neovascularization secondary to multiple evanescent white dot syndrome. Eur J Ophthalmol. 2007;17(6):996–9.PubMedGoogle Scholar
  14. Silva RA, Albini TA, Flynn Jr HW. Multiple evanescent white dot syndromes. Ocul Immunol Inflamm. 2012;2(2):109–11.Google Scholar

Copyright information

© Springer India 2016

Authors and Affiliations

  1. 1.Uveitis and Ocular Infectious Diseases Service – Eye Clinic, Department of Biomedical and Clinical Science “Luigi Sacco”Luigi Sacco Hospital, University of MilanMilanItaly

Personalised recommendations