To describe a clinical picture resembling classic multiple evanescent white dot syndrome (MEWDS) potentially triggered by previous or concurrent, apparently unrelated, ocular events and to provide a literature review of similar presentations.
Retrospective chart series and narrative review.
Consecutive sample of patients diagnosed with MEWDS at the Feinberg School of Medicine at Northwestern University (Chicago, Illinois) and IRCCS San Raffaele Scientific Institute (Milan, Italy) between July 2019 and June 2020.
Charts of patients were reviewed. Ophthalmic history, best-corrected visual acuity, spectral-domain optical coherence tomography, OCT angiography, fundus autofluorescence, ultra-widefield fluorescein angiography, and indocyanine green angiography were collected. A PubMed-based search was carried out for similar presentations using the terms “MEWDS” and “White spot syndromes”.
An ocular history positive for previous or concurrent ocular events in patients with MEWDS was sought in our cohort and the existing literature.
Five eyes of 4 patients (2 females, age 16-81 years) were included. The first eye had a history of bilateral Best vitelliform dystrophy and unilateral choroidal neovascularization. The second eye had angioid streaks complicated by choroidal neovascularization and underwent prior thermal laser photocoagulation. The third eye had a history of high myopia and scleral buckle for retinal detachment. The fourth patient had bilateral idiopathic retinochoroiditis. We identified 16 cases from 5 previous publications which support a MEWDS-like reaction to previous ocular insults.
and Relevance: We suggest a MEWDS-like reaction might be elicited by ocular events in a subset of susceptible subjects. We hypothesize damage to the outer retina may play a role in triggering the local inflammatory response.

Copyright © 2020. Published by Elsevier Inc.