Bhakhri Raman
*OD, FAAO Southern California College of Optometry, Fullerton, California.
Optom Vis Sci. 2013 Oct;90(10):e263-8. doi: 10.1097/OPX.0000000000000020.
This case report presents the diagnosis and management of a patient who was ultimately diagnosed as having multiple evanescent white dot syndrome (MEWDS), a rare retinal inflammatory disorder classified under the white dot syndromes.
A 34-year-old Hispanic woman presented with chief complaints of flickering lights and spots in her right eye that started 2 weeks earlier. Retinal examination revealed multiple white dots scattered across the retina, with an accompanying foveal granularity. Spectral domain optical coherence tomography and fundus autofluorescence were performed, which confirmed the diagnosis of MEWDS. The patient was monitored without treatment until resolution.
The etiology and pathogenesis of MEWDS remain unknown; fortunately, the natural course of the disease is favorable because almost all patients retain a good outcome without the need for treatment. This case highlights the importance of considering MEWDS and other white dot syndromes in the differential diagnosis of patients who present with a history of photopsia. Because many clinical findings are absent or very subtle when patients present, the clinician should consider supplemental testing such as spectral domain optical coherence tomography and fundus autofluorescence in aiding in the diagnosis.
本病例报告介绍了一名最终被诊断为多发性一过性白点综合征（MEWDS）患者的诊断及治疗情况，MEWDS是一种归类于白点综合征的罕见视网膜炎症性疾病。
一名34岁的西班牙裔女性，主要诉求为右眼出现闪光和光斑，始于2周前。视网膜检查发现多个白点散布于整个视网膜，并伴有黄斑颗粒状改变。进行了频域光学相干断层扫描和眼底自发荧光检查，确诊为MEWDS。对患者进行观察，未予治疗，直至症状缓解。
MEWDS的病因和发病机制尚不清楚；幸运的是，该病的自然病程良好，几乎所有患者无需治疗即可获得良好预后。本病例强调了在对有闪光幻视病史的患者进行鉴别诊断时，考虑MEWDS和其他白点综合征的重要性。由于患者就诊时许多临床体征缺失或非常细微，临床医生应考虑进行补充检查，如频域光学相干断层扫描和眼底自发荧光检查，以辅助诊断。
