Idiopathic multifocal choroiditis

Tavallali, Ali; Yannuzzi, Lawrence A.

doi:10.4103/2008-322x.194141

Cited by 40 publications

(36 citation statements)

References 26 publications

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“…(Ahnood et al 2017) Symptoms of MFC can include metamorphopsia, floaters, decreased vision and scotoma. (Tavallali & Yannuzzi 2016) Moreover, patients typically develop numerous central choroidal spots that usually form atrophic scars, without signs of ocular inflammation. A common complication is the development of choroidal neovascularization (CNV) inor adjacent toone or more of these choroidal spots.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of corticosteroid‐sparing immunomodulatory therapy in treating patients with central multifocal choroiditis

Groot

Loon

Boer

et al. 2020

Acta Ophthalmologica

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Purpose To evaluate the efficacy of corticosteroid‐sparing immunomodulatory therapy (IMT) in patients with recurrent and/or sight‐threatening central multifocal choroiditis (MFC). Methods This was a retrospective cohort study in a tertiary uveitis centre including all patients with MFC who have been treated with IMT for at least 12 months. Clinical data and imaging results were collected regarding the period prior to the start of IMT and at 3, 6, 12 and – where available – 24 months after the start of IMT. Main outcome measure was the number of annual recurrences of choroiditis with or without active choroidal neovascularization before and after the start of IMT. Secondary outcomes were the percentage of patients with (steroid‐free) remission and the median time between the start of IMT and (steroid‐free) remission. Results Thirty‐two patients (39 eyes) were included. At the start of IMT, none of the patients were in (steroid‐free) remission. At 24 months, the probability of achieving remission and steroid‐free remission was 88,5% and 50%, respectively. The median time to achieve remission and steroid‐free remission was 21 and 83 weeks, respectively. In 17 patients (20 eyes) with available clinical data and imaging results for ≥ 12 months prior to the start of IMT, the mean number of recurrences/year decreased significantly from 1.40 ± 0.81 at baseline to 0.49 ± 0.47 (p = 0.001) after the start of IMT. Conclusions Preventive therapy with IMT should be considered in patients with recurrent and/or sight‐threatening MFC to decrease the number of recurrences/year and to increase the prospects of achieving either remission or steroid‐free remission.

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Section: Introductionmentioning

confidence: 99%

The efficacy of corticosteroid‐sparing immunomodulatory therapy in treating patients with central multifocal choroiditis

Groot

Loon

Boer

et al. 2020

Acta Ophthalmologica

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“…Multifocal choroiditis (MFC) and punctate inner choroidopathy (PIC) are described as chronic progressive bilateral inflammatory chorioretinopathies that predominantly affect healthy myopic White women with infectious, noninfectious, or idiopathic causes. 1 Patients may complain of blurred vision, floaters, scotomas, metamorphopsias, photophobia, and photopsias. The inflammation results in the formation of multiple punched-out chorioretinal lesions with minimal or no anterior uveitis or vitritis.…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography angiography and choroidal neovascularization in multifocal choroiditis: A descriptive study

Dutheil¹,

Korobelnik

Delyfer

et al. 2018

European Journal of Ophthalmology

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“…As shown in the literature, these characteristic chorioretinal lesions in MCP generally have a yellow-white or grayish appearance in the outer retina and choroid at disease active stage, eventually progressing into punched-out pigmented scars or curvilinear chorioretinal streaks in a later stage. [1–3] Even though these lesions generally appears at mid-periphery retina, the documented poor visual prognosis in MCP was usually related to structural complications from ocular inflammation, such as cataracts, CME, ERM or CNV involving the macula. [13] Within these devasting complications, the development of CNV was the most common cause of vision loss.…”

Section: Discussionmentioning

confidence: 99%

“…[5] The MCP is typically treated with systemic corticosteroid therapy for inflammation control. [3] The differential diagnosis of MCP from other chorioretinopathies is made by 1st excluding any possible infectious entities. Clinical and morphological examinations are conducted using multi-modal imaging (MMI), including fluorescein angiography (FAG), indocyanine green angiography (ICGA), fundus autofluorescence (FAF), ultra-widefield retinal imaging, and optical coherence tomography (OCT).…”

Section: Introductionmentioning

confidence: 99%

Optical coherence tomography angiography in unilateral multifocal choroiditis and panuveitis

et al. 2019

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Rationale:Optical coherence tomography angiography (OCT-A) has the advantage to visualize the microvascular structure of the retina in vivo and was utilized clinically in various neovascular retinal diseases. The OCT-A has also been used to examine the lesion in multifocal choroiditis and panuveitis (MCP). This study aimed to describe a case of MCP and present the disease process of a punched-out lesion in the chorioretina with neovascular activity using OCT-A.Patients concerns:A 32-year-old female Caucasian patient presented with a 2-week history of progressive blurred vision in her right eye with photophobia and a diminished temporal visual field. On presentation, her best corrected visual acuity was 6/60 in the right eye with a prominent anterior uveitis seen under slit lamp examination.Diagnoses:Dilated fundus examination of the right eye showed vitritis and multiple, punched-out yellowish-white lesions over the peripheral retina. Additional multimodal imaging (MMI) were done including fluorescein angiography (FA), indocyanine green angiography (ICGA) and fundus autofluorescence (FAF), which all revealed characteristic findings of MCP. In general, the diagnosis of unilateral MCP was made. Furthermore, one of the punched-out lesions in the right eye was particularly selected and examined under OCT and OCT-A, which revealed a subretinal elevated lesion with high flow signal under OCT-A.Interventions:Treatment with oral prednisolone at 30 mg daily with topical prednisolone acetate 1% every 2 hours were prescribed, which were gradually tapered down within a 2-month course.Outcomes:The patient's best corrected visual acuity of the right eye returned to 6/6 at 2 months after the diagnosis. The flow signal in the OCT-A study of the punched-out lesion had also resolved after steroid treatment.Lessons:The MCP is an uncommon uveitis with multiple inflammatory chorioretinal lesions. Using multimodal imaging technique, physicians can better differentiate these lesions for diagnosis and for further monitoring. Our results demonstrated that these chorioretinal lesions in MCP may display neovascular activities that might not be seen easily using conventional FA or ICGA study. With OCT-A, ophthalmologists could identify and monitor subtle choroidal neovascularization (CNV) changes over these punched-out lesions.

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Idiopathic multifocal choroiditis

Cited by 40 publications

References 26 publications

The efficacy of corticosteroid‐sparing immunomodulatory therapy in treating patients with central multifocal choroiditis

The efficacy of corticosteroid‐sparing immunomodulatory therapy in treating patients with central multifocal choroiditis

Optical coherence tomography angiography and choroidal neovascularization in multifocal choroiditis: A descriptive study

Optical coherence tomography angiography in unilateral multifocal choroiditis and panuveitis

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