Multiple evanescent white dot syndrome.

Two Japanese young adults had an acute unilateral visual loss with no preceding general illness. Ophthalmoscopic examination revealed multiple, small discrete yellow-white lesions which appeared to be located at the level of the retinal pigment epithelium in the posterior fundus. There was also fine granularity of the fovea, and the optic disc margin was blurred. Fluorescein angiography demonstrated early hyperfluorescence of the lesions consisting of a cluster of punctate hyperfluorescent areas and late staining of the retinal pigment epithelium. These lesions regressed in a few weeks with return of the visual function to the normal level. The clinical picture of these cases is differentiated from acute inflammatory diseases primarily involving the retinal pigment epithelium and photoreceptors, and conforms to the multiple evanescent white dot syndrome that has recently been found in residents of the midwest region of the United States of America.