Indian Journal of Ophthalmology (Jan 2024)

A COVID-19 perspective of multiple evanescent white dot syndrome (MEWDS)

  • Himanshu Kashyap,
  • Anitha Manoharan,
  • Padmamalini Mahendradas,
  • Aniruddha Agarwal,
  • Parthopratim Dutta Majumder

DOI
https://doi.org/10.4103/IJO.IJO_2029_23
Journal volume & issue
Vol. 72, no. 5
pp. 620 – 625

Abstract

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Multiple evanescent white dot syndrome (MEWDS) is a rare form of posterior uveitis characterized by involvement in the posterior pole and mid-periphery. A viral etiology that provokes an immune-mediated response has been hypothesized to be the inciting factor of the pathology. Recently, there has been an increase in the literature regarding new-onset uveitis and reactivation of previously diagnosed cases of uveitis following COVID-19 vaccinations. The COVID-19 vaccination has been speculated to trigger an immunomodulatory shift in recipients, resulting in an autoimmune event. MEWDS following COVID-19 vaccination was reported in 31 patients. It was most commonly observed following the first dose, affecting 15 patients, and least commonly after the booster dose, in only one patient. MEWDS-like disease following anti-SARS-CoV-2 vaccinations was reported the most in 16 cases after the Pfizer–BioNTech vaccination (BNT162b2 mRNA). Most of these cases had Primary MEWDS without any previous history of a similar event in the past.

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