LAUSR

Secondary multiple evanescent white dot syndrome is an epiphenomenon (“EpiMEWDS”) that may be seen in association with clinical manifestations disruptive to the choriocapillaris–Bruch membrane–retinal pigment epithelium complex. Purpose: To analyze the nature of multiple evanescent white dot syndrome (MEWDS) and differentiate an idiopathic or primary form of MEWDS from a secondary form that is seen in association with other clinical conditions affecting the posterior segment of the eye. Methods: Clinical and multimodal imaging findings including color fundus photography, fundus autofluorescence, fluorescein angiography, indocyanine green angiography, spectral-domain optical coherence tomography, and optical coherence tomography angiography of patients with secondary MEWDS are presented. Results: Twenty consecutive patients with secondary MEWDS were evaluated. Fifteen patients were female. Most were young adults aged between 20 to 40 years with myopia (less than −6 diopters). Pathologic conditions associated with the secondary MEWDS reaction were high myopia (greater than −6 diopters) in two eyes, previous vitreoretinal surgery for rhegmatogenous retinal detachment in 2 eyes, and manifestations of multifocal choroiditis in 18 eyes. In all eyes, the MEWDS lesions followed a course of progression and resolution independent from the underlying condition. Conclusion: Secondary MEWDS seems to be an epiphenomenon (“EpiMEWDS”) that may be seen in association with clinical manifestations disruptive to the choriocapillaris–Bruch membrane–retinal pigment epithelium complex.