Multiple evanescent white dot syndrome following influenza immunization - A multimodal imaging study

PURPOSE: To describe the multimodal imaging (MMI) findings and clinical course of a case of Multiple Evanescent White Dot Syndrome (MEWDS) following immunization with inactivated intra-dermal influenza virus, and to explore whether similarities exist with other, previously reported cases. OBSERVATIONS: A 34-year-old Caucasian man presented with unilateral onset of para-central scotomata, photopsias, and dyschromatopsia two weeks after administration of an influenza vaccine. Clinical examination and MMI were indicative of MEWDS. The patient's MMI abnormalities and symptoms resolved spontaneously after four weeks. CONCLUSION AND IMPORTANCE: This is the first reported case of MMI of post-influenza vaccination-associated MEWDS. Comparison with eight previously reported cases of MEWDS following various immunizations revealed that subjects tended to be healthy, young to middle age women with a median time to onset of two weeks. Vision tended to recover spontaneously over one to three months.