Article Text

Download PDFPDF
Multiple evanescent white dot syndrome: clinical course and factors influencing visual acuity recovery
  1. Francesca Bosello1,2,
  2. Mark Westcott1,
  3. Giuseppe Casalino1,3,
  4. Georgios Agorogiannis1,
  5. Rocco Micciolo4,
  6. Angela Rees1,
  7. Carlos Pavesio1
  1. 1 Medical retina and Uveitis Service, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
  2. 2 Department of Neurosciences, Biomedicine and Movement Sciences, Eye Clinic, AOUI-University of Verona, Verona, Italy
  3. 3 Oftalmico Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
  4. 4 Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
  1. Correspondence to Francesca Bosello, Medical Retina and Uveitis Service, Moorfields Eye Hospital, NHS Foundation Trust, London, UK; francesca.bosello87{at}


Objective To report the demographics and the clinical course of patients with multiple evanescent white dot syndrome (MEWDS) and to investigate for those factors which influence visual acuity (VA) recovery.

Methods This is a retrospective single-centre observational study. Electronic medical records and retinal imaging of patients with a diagnosis of MEWDS with a minimum follow-up of 3 months were reviewed. Patients were categorised into three groups according to the VA at presentation and at the last visit: group 1 >0.48 logarithm of the minimum angle of resolution (LogMAR), group 2 ≤0.48 and ≥0.18 LogMAR and group 3 <0.18 LogMAR. All patients had non-invasive multimodal imaging including optical coherence tomography, near-infrared reflectance imaging and blue fundus autofluorescence at presentation and during follow-up.

Results A total of 51 eyes from 51 patients (41 women, mean age 29.8±7.8 years) were included. Significantly more patients presented in the autumn (X2=8.69, p=0.034). The percentage of eyes recovering vision to 0.0 LogMAR or better was 80.3% (41/51). Worse presenting vision and young age at presentation were independent significant predictive variables for poorer final VA (p=0.002 and p=0.02, respectively). No imaging features were significantly predictive of complete versus incomplete recovery, but disc hyperfluorescence on fluorescein angiography was more common in those with incomplete recovery.

Conclusions Although the majority of cases have a benign prognosis, the clinical spectrum of MEWDS includes incomplete visual recovery. In our series, poor presenting VA and young age were associated with poor VA outcome. Further study is warranted to confirm these findings.

  • Retina
  • Inflammation
  • Imaging

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors FB, MW, GC and CP are responsible for the overall content as guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplemental information.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

Linked Articles

  • At a glance
    Frank Larkin