Researchers at Moorfields Eye Hospital in London have determined that the clinical spectrum of multiple evanescent white dot syndrome (MEWDS) seems to be wider than previously reported. Although the majority of cases have a benign prognosis, their study identified to significant risk factors for incomplete recovery: poor presenting visual acuity (VA) and young age.
The study reviewed electronic medical records and retinal imaging of 51 patients with a diagnosis of MEWDS with a minimum follow-up of three months. The cohort was divided into three groups according to the VA at presentation and at the last visit: group 1, above 0.48logMAR; group 2, between 0.48logMAR and 0.18logMAR; and group 3, under 0.18 logMAR. The percentage of eyes recovering vision to 0.0logMAR or better was 80.3%. Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA.
The researchers note that the condition is predominantly a disease of young women, as 80.4% of the study participants were women with a mean age of 29.8±7.8. Less than one-third of cases presented after a viral prodrome with various visual symptoms such as photopsia, blurred vision, floaters and scotoma, they added.
“We have found an interesting seasonality of this disease, with most cases presenting in the mid-seasons, especially in the autumn.”
The researchers are hopeful that their results may influence future treatment strategies for the subgroups of patients that they helped identify.
Bosello F, Westcott M, Casalino G, et al. Multiple evanescent white dot syndrome: clinical course and factors influencing visual acuity recovery. Br J Ophthalmol. October 21, 2020. [Epub ahead of print].