multiple evanescent white-dot syndrome

multiple evanescent white-dot syndrome

A condition primarily affecting young (age 14–47), myopic women (female:male, 5:1), who present with acute, painless, unilateral change in vision. Patients may notice photopsias, dyschromatopsia, and temporal or paracentral scotoma; up to 50% of patients report a prodromal viral illness.
Clinical findings
Acute unilateral or markedly asymmetric visual blurring, scotomata in temporal field, often emanating from the blind spot; shimmering photopsias are common and located within scotomas.
 
Diagnosis
Fluorescein angiography (early punctate hyperfluorescence and late staining corresponding to the white dots).
 
Prognosis
Spontaneous recovery of vision usually occurs over 3–10 weeks with disappearance of the white dots; foveal granularity usually takes longer to resolve and may be replaced by pigment mottling; patients may exhibit persistent blind-spot enlargement; because of its favourable natural history, no treatment is indicated for typical cases; laser photocoagulation may be necessary.

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