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The pathogenesis of MEWDS remains to be elucidated. An immunological process is suggested by the association with recent viral illnesses, descriptions of cases occurring soon after vaccinations, and an increased frequency of HLA-B51 in affected patients. Since a large proportion of patients have been using oral contraceptive medications, the possibility of hormonal influence has also been raised.
MEWDS has been considered part of a spectrum of overlapping conditions with similar symptoms and preponderance among young women. Examples include acute macular neuroretinopathy, multiple choroiditis with panuveitis, acute idiopathic blind spot enlargement syndrome and acute zonal occult outer retinopathy. These conditions may represent variations of a single disease entity. Alternatively, the overlapping clinical features may represent common findings in diseases with entirely different etiologies.
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