title: Progressive confluent circumpapillary multiple evanescent white-dot syndrome.
abstract: OBJECTIVE
  To describe a morphologic variant of the multiple evanescent white-dot syndrome that can mimic other conditions.
  
  
  METHODS
  We examined three patients with severe cases of unilateral multiple evanescent white-dot syndrome characterized by an atypical progressive circumpapillary discoloration of the fundus.
  
  
  RESULTS
  The confluent circumpapillary lesion progressed toward or beyond the equator of the fundus, raising initial concern of a viral retinitis. However, pinpoint dots at the leading edge evolved into the typical wreath-like spots of multiple evanescent white-dot syndrome, which then coalesced into the advancing edge of a geographic retinitis or retinal pigment epitheliitis, before spontaneous resolution.
  
  
  CONCLUSIONS
  Progressive geographic circumpapillary discoloration, appearing as a giant white spot, occurs rarely in severe cases of multiple evanescent white-dot syndrome. The distinctive appearance may suggest a disorder other than multiple evanescent white-dot syndrome, which can make initial diagnosis more difficult and lead to unnecessary or inappropriate testing and treatment.
authors.affiliation: Department of Ophthalmology, School of Medicine, Stanford University, Stanford, California, USA.
authors.forename: J K
authors.initials: JK
authors.lastname: Luttrull
authors.forename: M F
authors.initials: MF
authors.lastname: Marmor
authors.forename: M
authors.initials: M
authors.lastname: Nanda
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D009898:Optic Disk / Q000473:pathology*; D012164:Retinal Diseases / Q000175:diagnosis*; D013577:Syndrome; D014792:Visual Acuity