Peripapillary pigment epitheliopathy as a sequel of multiple evanescent white-dot syndrome

Multiple evanescent white-dot syndrome (MEWDS) is a self-limited disease in most patients. We report three young female patients with unilateral persistent blind spot enlargement after MEWDS. All three patients had flu-like symptoms before blurred vision occurred. After the disappearance of the white dots, the patients had persistent dense visual field defect with photopsia. Although the visual acuity recovered in two patients after one year of follow-up, the visual field defect of blind spot enlargement persisted in all three. The fluorescein angiography examinations showed a variable extent of depigmentation on the peripapillary area, which is compatible with an enlargement of the blind spot. Most patients with MEWDS often have a fair prognosis, although this syndrome may cause permanent blind spot enlargement and peripapillary pigment epitheliopathy in some patients.