OPTIC DISK PIT: A TRIGGER FOR SECONDARY MULTIPLE EVANESCENT WHITE DOT SYNDROME.
Shivesh Varma, Royce W S Chen, Jeffrey M Liebmann et al.
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Case in brief
A 41-year-old man with a right optic disk pit presented with right-eye visual loss and photopsia; visual acuity was 20/100. Clinical examination and multimodal imaging supported unilateral multiple evanescent white dot syndrome (MEWDS). Lesion distribution suggested a possible relationship to the disk pit. Fundus autofluorescence showed hyperautofluorescent spots that faded on serial imaging, without hyperautofluorescent dots. At 3 months, visual acuity had recovered to 20/25.
What made this case unusual
The proposed secondary MEWDS associated with an optic disk pit showed hyperautofluorescent spots without the dots described in primary MEWDS; the authors hypothesize this imaging pattern may help distinguish the two.
Diagnostic / clinical pearl
In a patient with MEWDS-like findings and an optic disk pit, consider a possible secondary association and assess lesion distribution alongside multimodal imaging.