Multiple Evanescent White Dot Syndrome: A Case Report and Experience with Corticosteroid Therapy
MEWDS treatment by low dose corticosteroid
Multiple evanescent white dot syndrome (MEWDS) is an inflammatory eye disease of the outer retina, retinal pigmented epithelium, choroid presenting with photopsia, loss of vision, and temporal scotoma. The patient was a 31-year-old female with a history of vision loss since 11 days ago (left eye). At presentation, best-corrected Snellen visual acuity was 20/140 in the Snellen chart. We decided to treat her with short time corticosteroid therapy (0.75 mg/kg/day prednisolone which was tapered in 3 weeks) for any possible rapid recovery of vision. The visual acuity of the involved eye was improved to 20/25 and 20/20, one week and three weeks after starting treatment respectively. Thus, it seems that short-term oral steroids might be an alternative method of management for patients with MEWDS.
2. Fine L, Fine A, Cunningham ET. Multiple evanescent white dot syndrome following hepatitis A vaccination. Arch Ophthalmol. 2001;119(12):1856-8.
3. Baglivo E, Safran AB, Borruat F-X. Multiple evanescent white dot syndrome after hepatitis B vaccine. Am J Ophthalmol. 1996;122(3):431-2.
4. Jampol LM, Sieving PA, Pugh D, Fishman GA, Gilbert H. Multiple evanescent white dot syndrome: I. Clinical findings. Arch Ophthalmol. 1984;102(5):671-4.
5. Lavigne LC, Isaac DLC, Júnior D, Osório J, Ávila MPd. Transient spectral domain optical coherence tomography findings in classic MEWDS: a case report. Arq Bras Oftalmol. 2014;77(3):185-7
6. Crawford CM, Igboeli O. A review of the inflammatory chorioretinopathies: the white dot syndromes. ISRN inflammation. 2013;2013:783190.
7. Nguyen MHT, Witkin AJ, Reichel E, Ko TH, Fujimoto JG, Schuman JS, et al. Microstructural abnormalities in MEWDS demonstrated by ultrahigh resolution optical coherence tomography. Retina. 2007;27(4):414-8.
8. Rouvas A, Ladas I, Papakostas T, Moschos M, 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.
9. Callanan D, Gass JDM. Multifocal choroiditis and choroidal neovascularization associated with the multiple evanescent white dot and acute idiopathic blind spot enlargement syndrome. Ophthalmology. 1992;99(11):1678-85.
10. Nomura Y. A case of multiple evanescent white dot syndrome treated by steroid pulse therapy. Osaka City Med J. 2006;52(2):83-6.
11. Ogino K, Kishi S, Yoshimura N. Multiple evanescent white dot syndrome after human papillomavirus vaccination. Case Rep Ophthalmol. 2014;5(1):38-43
12. Fernández-Barrientos Y, Díaz-Valle D, Méndez-Fernández R, Benítez-Del-Castillo JM. Possible recurrent multiple evanescent white dot syndrome and chroroidal neovascularization. Arch Soc Esp Oftalmol. 2007;82(9):587-90.