Multiple evanescent white dot syndrome in patients with multifocal choroiditis

Background: Controversy exists as to whether a common causal entity is responsible for multifocal choroiditis (MFC) and multiple evanescent white dot syndrome (MEWDS). It is commonly known that patients with MEWDS can later develop manifestations of MFC, but the reverse is rarely seen. Purpose: To report cases of MEWDS in patients previously diagnosed with MFC. Design: Retrospective case series. Participants: Four female patients 29 to 34 years old. Methods: The charts of four patients with acute unilateral onset of MEWDS and evidence of previous MFC were examined retrospectively. Main Outcome Measures: Photographic and angiographic interpretation of fundus appearance. Results: At the time of diagnosis with typical MEWDS, one patient had a documented previous episode of acute MFC; one patient had previous bilateral choroidal neovascularization associated with discrete, posterior atrophic scars; and two patients had peripheral discrete chorioretinal pigmented lesions and peripapillary atrophy. Conclusions: MEWDS may occur after MFC. Now that both directions of disease progression, MFC to MEWDS and MEWDS to MFC, have been well documented, it is likely that there is a common host susceptibility between these two distinct clinical diseases, if not a common pathogenesis.