Multiple evanescent white dot syndrome following rabies vaccination: a case report

BACKGROUND: To report a case of multiple evanescent white dot syndrome (MEWDS) following simultaneous rabies vaccination. CASE PRESENTATION: Review of the clinical, laboratory, photographic, optical coherence tomographic (OCT), fundus autofluorescent, angiographic, electrophysiologic, and perimetric records of a patient suffering from MEWDS. Results: A healthy 33-year-old Chinese female suffering from rapidly progressive visual loss of her left eye associated with photopsia and a para-central scotoma, seven days after receiving simultaneous rabies vaccination. Both anterior segments and fundus examination were unremarkable. The findings on OCT, electrophysiology, and perimetry were pathognomonic for MEWDS. CONCLUSIONS: The clinical presentation and the benign course were consistent with the diagnosis of MEWDS. No other events could be identified as a cause, other than the rabies vaccination. This case may suggest an autoimmune basis for MEWDS in predisposed patients.