Yoon Kit Ivan LAI, Pooi Wah LOTT, Wardati Hanisah JAMI, Rajasudha Sawri RAJAN
Retina-Vitreus - 2026;35(3):304-310
Purpose: MEWDS is a rare posterior uveitis, typically affecting young myopic females and presents as an acute, unilateral photoreceptor disease with multifocal whitish dots appearing throughout the retina. It is a rare disease and we observe an unusual cluster of MEWDS cases following SARS-CoV-2 infection and vaccination over two months. Methods: Descriptive Case Series of MEWDS encountered in 2022 at Hospital Selayang, Malaysia. All patients underwent slit lamp examination and multimodal imaging, including fundus photography, SD-OCT, Blue-Light Autofluorescence (BL-FAF), Fundus Fluorescein Angiography (FFA) and Indocyanine Green Angiography (ICGA). Results: Three cases of MEWDS were encountered, with 2 female and 1 male (2:1). Mean age of presentation was 34 years old. Two patients received SARS-CoV-2 booster vaccination 21 and 28 days prior and one had SARS-CoV-2 infection 26 days before presentation. All had unilateral disease with presenting visual acuity ranging from 6/9 to 6/60. All patients had multiple yellow-white subretinal lesions in their affected eye. Disc hyperemia, mild vitritis and foveal granularity were also present. Multimodal Imaging (MMI) confirmed the MEWDS diagnosis. 2 patients were commenced oral prednisolone due to reduced visual acuity, while 1 patient was treated with topical steroids as visual acuity was unaffected. All patients had full visual recovery by 8 weeks. Conclusion: Both of our post vaccination patients developed MEWDS following booster dose administration, contrasting with published literature where majority of MEWDS cases occurred with the initial vaccination doses. Given the current evidence, only a temporal association can be inferred with further research required to suggest causality.
