White Dot Syndromes

The white dot syndromes constitute a group of inflammatory chorioretinopathies. The common, defining clinical feature is the presence of multiple, discrete, white lesions located at the deeper levels of the retina choroid. Several white dot syndromes are associated with a viral prodrome; an etiology is lacking for these conditions. Typically seen in young, otherwise healthy adults, the white dot syndromes most often present with symptoms of photopsia, floaters, decreased night vision, blurred vision, and visual field loss. These conditions can be acute in onset or transient without long-term visual consequence. White dot syndromes share similar clinical features, including the "tell-tale" chorioretinal lesions, several distinct clinical features, and diagnostic testing findings that allow for additional characterization. Commonly recognized white dot syndromes include Multiple evanescent white dot syndrome (MEWDS), acute retinal pigment epitheliopathy (ARPE), acute posterior multifocal placoid pigment epitheliopathy (APMPPE), multifocal choroiditis and panuveitis (MCP), acute zonal occult outer retinopathy (AZOOR), birdshot chorioretinopathy, serpiginous choroidopathy, and punctate inner choroidopathy (PIC). These conditions are conventionally recognized as distinct identities, and some suggest that they represent a spectrum of chorioretinal diseases.