Topic outline

  • Grand Rounds

    A healthy, myopic 18-year-old female presented with 2 days of blurry vision in her left eye after having a viral upper respiratory infection for 1 week. Dilated fundus exam revealed posterior pole gray-white spots sparing the fovea and a granulated foveal appearance, as well as mild posterior vitreous cell. Diagnostic imaging showed hyperautofluorescent spots on fundus autofluorescence, early hyperfluorescent dots and late staining spots, as well as late staining of the disc, on fluorescein angiography, hypofluorescent spots in the late phase of ICG angiography, and multifocal EZ disruption with hyperreflective material in the outer nerve layer on OCT. A presumed diagnosis of MEWDS was made. Lab workup was obtained to rule out masquerade syndromes and resulted within normal limits. She was observed and after 1 month had complete resolution of her symptoms and of the spots on fundus examination, as well as almost complete resolution of the hyperautofluorescent spots on fundus autofluorescence and restoration of the photoreceptor layer on OCT.

    Presentation Date: 02/27/2020
    Issue Date: 08/01/2020