Multiple evanescent white dot syndrome and multiple sclerosis

Purpose.- To describe a patient who fulfilled the criteria for both clinically definite multiple evanescent white dot syndrome (MEWDS) and multiple sclerosis. Methods.- We performed a complete ophthalmologic and neurological examination in a 30-year-old woman who was referred to our department for blurred vision in her left eye (LE) with photopsia. Results.-Following a complete ophthalmologic examination, the patient was diagnosed with MEWDS and coincident multiple sclerosis. She underwent therapy with intravenous methylprednisolone (1000 mg/day) for three days, followed by oral prednisone (1 mg/kg per day) for 15 days. Most of the symptoms and signs apparently regressed within one month, despite a still abnormal OCT macular scan, probably due to atrophic post-inflammatory changes in the outer and photoreceptor layers (rods and cones). Conclusion.- This report, showing the clinical features of MEWDS associated with multiple sclerosis, strongly suggests common neuropathological and inflammatory mechanisms between MS and white dot syndromes. (C) 2010 Elsevier Masson SAS. All rights reserved.