A case of multiple evanescent white dot syndrome misdiagnosed as optic neuritis: Differential diagnosis for the neurologist

Abstract

A 25-year-old female presented to a local hospital for acute onset of a central scotoma in the left visual field. She was visited by the neurologist, and a diagnosis of left retrobulbar optic neuritis was made. Magnetic resonance imaging scan was normal. Ophthalmic examination revealed a multiple evanescent white dot syndrome. After a description of the case, a brief differential diagnosis between these two entities is made. The neurologist should be aware of this uncommon condition.

Keywords: Multiple evanescent white dot syndrome; optic neuritis; visual loss.

Figure 1

Granular appearance of the macula is pathognomonic of the condition

Figure 2

Retinography of the left eye. Arrows indicate residual white dots

Figure 3

Optical coherence tomography scan of the fovea outer segment shows disruption at the inner segment/outer segment junction of photoreceptor layer in the macula

Figure 4

Posterior pole autofluorescence outer segment shows multiple white dots concentrated in the peripapillary area