Wiley Zachary C, Pakravan Mohammad, Charoenkijkajorn Chaow, Kavoussi Shawn C, Lee Andrew G
Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA.
Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.
Am J Ophthalmol Case Rep. 2022 Apr 20;26:101538. doi: 10.1016/j.ajoc.2022.101538. eCollection 2022 Jun.
To report a uveomeningeal syndrome with bilateral optic disc edema and a MEWDS-like presentation.
A 17-year-old female experienced daily fevers for 3 days (ranging from 101.4 F to 102 F), then received the first dose of the Pfizer SARS-CoV-2 vaccine nearly three weeks later. Within two days she experienced severe headaches with severity scale of 8/10. Retinal imaging at the time showed optic disc edema in both eyes (OU) and multifocal well-circumscribed chorioretinal white lesions in the periphery OU. Neuroimaging and routine infectious and inflammatory laboratory testing were normal. Lumbar puncture showed elevated opening pressure and cerebrospinal pleocytosis consistent with an aseptic meningitis. At follow up, one month later the symptoms and retinal findings resolved.
MEWDS is typically an idiopathic condition but can occur in the setting of viral illness. Although other white dot syndromes have been associated with uveomeningeal presentations, to our knowledge this is the first such case to be described in the English language ophthalmic literature.
报告一例伴有双侧视盘水肿及类似多发性一过性白点综合征（MEWDS）表现的葡萄膜脑膜综合征。
一名17岁女性连续3天每日发热（体温在101.4华氏度至102华氏度之间），近三周后接种了第一剂辉瑞新冠病毒疫苗。两天内，她出现了严重头痛，疼痛程度为8/10。当时的视网膜成像显示双眼视盘水肿，双眼周边有多发边界清晰的脉络膜视网膜白色病变。神经影像学检查以及常规感染性和炎症实验室检查均正常。腰椎穿刺显示初压升高，脑脊液细胞增多，符合无菌性脑膜炎表现。在一个月后的随访中，症状和视网膜表现均已消退。
MEWDS通常是一种特发性疾病，但可在病毒感染的情况下发生。尽管其他白点综合征与葡萄膜脑膜表现有关，但据我们所知，这是英文眼科文献中首次描述的此类病例。
