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—We agree with Dr Aaberg that MEWDS and acute idiopathic blind spot enlargement have one important feature in common: they both involve the retina. Here their similarity ends. Acute idiopathic blind spot enlargement is a scotoma syndrome in which visual loss is peripapillary, absolute in density, and steep-edged at the margins. In MEWDS, there are decreased visual acuity, anterior chamber and vitreous reaction, visible deep retina lesions, and no dense scotomas.The late-stage fluorescein angiograms in patients 2 and 7 did not show leakage. Ophthalmoscopic evidence of disc edema was absent in all seven patients. None of our patients had symptoms of a flulike illness preceding their visual symptoms.Acute idiopathic blind spot enlargement remains a retinal disease without an explanation.
Hoty WF, Imes RK. Multiple Evanescent White Dot Syndrome-Reply. Arch Ophthalmol. 1988;106(9):1163. doi:10.1001/archopht.1988.01060140322007