A COVID-19 perspective of multiple evanescent white dot syndrome (MEWDS)

Abstract

Multiple evanescent white dot syndrome (MEWDS) is a rare form of posterior uveitis characterized by involvement in the posterior pole and mid‑periphery. A viral etiology that provokes an immune‑mediated response has been hypothesized to be the inciting factor of the pathology. Recently, there has been an increase in the literature regarding new‑onset uveitis and reactivation of previously diagnosed cases of uveitis following COVID‑19 vaccinations. The COVID‑19 vaccination has been speculated to trigger an immunomodulatory shift in recipients, resulting in an autoimmune event. MEWDS following COVID‑19 vaccination was reported in 31 patients. It was most commonly observed following the first dose, affecting 15 patients, and least commonly after the booster dose, in only one patient. MEWDS‑like disease following anti‑SARS‑CoV‑2 vaccinations was reported the most in 16 cases after the Pfizer–BioNTech vaccination (BNT162b2 mRNA). Most of these cases had Primary MEWDS without any previous history of a similar event in the past.