Over‐interpreting white dots

Summary The white dot syndromes are a group of inflammatory chorioretinopathies of unknown etiology which have in common a unique and characteristic appearance of multiple yellow‐white lesions affecting multiple layers of the retina, retinal pigment epithelium ( RPE ), choriocapillaris, and the choroid. They also have overlapping clinical features. For example, multifocal choroiditis and punctate inner choroidopathy target the same essential structures in the same phenotypic manner and, when active, are treated the same way, and thus there seems to be limited clinical utility in trying to differentiate them. Transitions between the individual diseases have also been described, and when a prolonged progressive clinical course and widespread distribution of lesions is present, the term “relentless” is now applied. Neither the trigger mechanism nor the pathogenetic development is known with certainty for any of these diseases. Immunological reactions to previous viral infections coupled with a genetic predisposition seem to be a common denominator. Some of these conditions share an association with systemic infectious diseases.