Multiple Evanescent White Dot Syndrome After Vaccination for Human Papilloma Virus and Meningococcus

Journal of Pediatric Ophthalmology & Strabismus • Vol. xx, No. x

Steven M. Cohen, MD

From the University of South Florida School of Medicine, Tampa, Florida.
Originally submitted July 10, 2008. Accepted for publication October 29, 2008.

The author has no financial or proprietary interest in the materials presented herein.

Multiple evanescent white dot syndrome is a rare chorioretinopathy causing transitory vision loss, usually in females and generally in one eye. In 2007, widespread vaccination of older children against human papilloma virus and meningococcus was recommended by the Centers for Disease Control and Prevention. A 17-year-old girl presented with multiple evanescent white dot syndrome 1 month after receiving these two vaccinations. [J PediatrOphthalmol Strabismus 200X;XX:XX-XX.]

INTRODUCTION
Patients with multiple evanescent white dot syndrome (MEWDS), a rare chorioretinopathy, usually present with mild to moderate vision loss, central and paracentral scotomata, and floaters.1 Signs and symptoms of MEWDS are evanescent, usually lasting 4 to 6 weeks. Most patients experience a flu-like illness approximately 1 month before the onset of visual symptoms. In the initial report of MEWDS by Jampol et al.2 in 1984, 10 of 11 patients were women 20 to 38 years old. The youngest known patient to have MEWDS was 10 years old.3 There has also been a report of MEWDS after hepatitis A vaccination and hepatitis B vaccination.4,5

In March 2007, the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices recommended the human papilloma virus (HPV) vaccine for all girls 11 to 12 years old and for girls and women 13 to 26 years old who have not yet been vaccinated.6,7 The HPV vaccine is administered as a series in a three-doseschedule.8 In August 2007, the Advisory Committee recommended meningococcal conjugate vaccine for all individuals 11 to 18 years old.9  To the author’s knowledge, this report is the first to describe a case of MEWDS in an adolescent girl who had recently received these two vaccinations.

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