What Is White Dot Syndrome?
White Dot Syndromes are a collection of eye disorders characterized by whitish-yellow lesions that affect the layers of the retina. White Dot Syndromes are inflammatory reactions most frequently diagnosed in young, otherwise healthy adults. Symptoms of white dot syndromes can include flashes of light, floaters, acute vision loss and loss of peripheral vision. Examples of white dot syndromes are birdshot retinochoroidopathy, multifocal choroiditis, and toxocariasis.
Key Takeaways
- White Dot Syndromes are a group of eye diseases involving white-yellowish lesions inside of the retina.
- White dot syndromes are inflammatory reactions due to immune dysfunction, and often occur after a viral illness.
- Symptoms of white dot syndromes can include flashes of light, floaters, acute vision loss and loss of peripheral vision.
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Understanding White Dot Syndrome
White Dot Syndromes are a group of eye disorders that are inflammatory chorioretinopathies, which are disorders of the choroid and retina. The retina is the thin layer of light-sensitive tissue that lines the back of the eye like wallpaper. The choroid is the layer of blood vessels that is behind the retina. White dot syndromes primarily affect the outer retinal layers and the choroid.
The main characteristic of retinal white dot syndrome is the development of multiple distinctive white or cream-colored chorioretinal lesions. These lesions have unknown etiology, meaning that the cause of these lesions is unknown. However, it is suspected that retinal white dot syndrome is autoimmune or inflammatory in nature. Patients with this disorder may initially have viral-like illness of the body, with symptoms such as fever, nausea, and headaches. These symptoms usually precede the onset of sudden, painless vision loss. Retina white dot syndromes typically affect women in their late thirties but can occur in both men and women between 15 to 45 years of age.
Symptoms of white dot syndrome may include:
- Sudden, painless blurry vision
- Mild light sensitivity
- Flashes of light
- Floaters
- Black spot in vision
- Viral illness symptoms such as fever, nausea, chills, headache, or sore throat
Diseases That Constitute White Dot Syndrome
White dot syndrome include: Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE), serpiginous choroiditis, Multiple Evanescent White Dot Syndrome (MEWDS), birdshot retinochoroidopathy, and histoplasmosis.
- Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE)
APMPPE causes acute vision loss in adults, oftentimes after viral illness. Creamy, white, subretinal lesions are present in both eyes. These lesions typically spontaneously resolve and disappear over the course of weeks to months. This condition does not usually require treatment. - Serpiginous Choroidopathy
Serpiginous choroidopathy is a rare clinical condition that causes yellow-white lesions in both eyes that extend from the optic nerve outwards. This condition usually affects adults between 30 to 60 years old. Systemic corticosteroids are used to treat this condition, although it has a high rate of recurrence. The most common complication is choroidal neovascularization, which results in blood leaking from the choroid into the retina. - Multiple Evanescent White Dot Syndrome (MEWDS)
MEWDS usually affects one eye only. It causes sudden vision loss in one eye, and usually affects young females after viral illness. There is typically no treatment required for this condition and the vision returns to normal spontaneously within a few weeks. Flashing lights or shimmering lights in the vision are unique symptoms of MEWDS. - Birdshot Retinochoroidopathy
Birdshot retinochoroidopathy is also known as birdshot chorioretinopathy. Yellow-white lesions can occur in the retina due to chronic, bilateral, and posterior uveitis, which is inflammation. The condition mainly affects Caucasian females between the ages of 40 and 60. It is usually treated with systemic immunosuppression. - Histoplasmosis
Ocular histoplasmosis is an eye condition caused by Histoplasma capsulatum fungus present in the Ohio and Mississippi river valley regions. It usually infects patients aged 20 to 50 years old after the spores are inhaled. The classic triad of ocular findings for histoplasmosis are chorioretinal scars, peripapillary atrophy, and a choroidal neovascular membrane. These chorioretinal scars can appear like white dots, hence this condition is part of the white dot syndromes.
