Multifocal and recurrent (serous) choroidopathy (MARC) syndrome: A new variety of idiopathic central serous choroidopathy

Abstract

Presented is a group of 110 patients with patches of granular atrophy of the retinal pigment epithelium which I believe represents a new subtype of idiopathic central serous choroidopathy (ICSC). It is designated as multifocal and recurrent (serous) choroidopathy (MARC) syndrome. Such patients are the 'older' ICSC patients and they usually have bilateral involvement which may show marked asymmetry. The history is seldom helpful in defining previous episodes of leaking. The fundus changes are thought to represent the sequelae of multiple, recurrent, or chronic choroidopathy in the form of serous detachments of the retinal pigment epithelium and/or neurosensory retina. Such detachments may not be present at the time of a single examination, and thus the fundus picture may be puzzling without an awareness of this syndrome which exhibits a wide spectrum of severity. Difficulties in detecting the low detachments and fluorescein leaking are emphasized. There is often a marked disparity between the ophthalmoscopic and the fluorescein angiographic pictures, and examination by the latter technique is urged. I do not believe this entity progresses to senile disciform disease, but can result in marked visual loss. If extrafoveal leaking is found in the presence of decreased acuity and a macular detachment, and if there is evidence of previous attacks, photocoagulation can effectively flatten the retina. I believe photocoagulation therapy under these conditions is justifiable.

Bilateral multifocal and recurrent chorioretinopathy - case report

“…Multifocal, recurrent serous chorioretinopathy was the final diagnosis in our case. The patient's gender and age corresponded to those of a patient with typical CSRS, but the chronic variant is rare in Caucasian individuals [1]. Our patient does not present the classic risk factors: he was not exposed to corticosteroid therapy before admission in the ophthalmology clinic, nor did he declare the presence of a significantly stressful life event prior to the beginning of the ocular symptoms.…”

“…While facing a case of multifocal, recurrent serous chorioretinopathy, the diagnosis is not the only challenging aspect, but also finding the right treatment for the patient. When the pathology was first described as MARC Syndrome, the only known effective treatment was photocoagulation [1]. In the 21st century, the treatment options are numerous without the presence of a certified gold standard.…”

“…Multifocal, recurrent serous chorioretinopathy is a rare pathology first described as an independent entity known as MARC (multifocal and recurrent choroidopathy) syndrome in 1984 [1]. Nowadays, it is considered the rare chronical form of Central Serous Chorioretinopathy (CSCR) affecting most frequently otherwise healthy middle-aged men with Asian descendants.…”

Diffuse Retinal Pigment Epitheliopathy among the Inhabitants of Brahmaputra Valley of India

“…Castro-Correia and associates (12) thought it to be the terminal state of most severe cases of CSC. Several investigators (3,(7)(8)(9)(10)(11)(12)(16)(17)(18) are of the opinion that the visual prognosis is grave in many of these cases. CSC is not uncommon among the inhabitants of the Brahmaputra Valley of India.…”

Photodynamic Therapy With Verteporfin in Subfoveal Choroidal NeovascularizationSecondary to Central Serous Chorioretinopathy

“…This generally resolves without therapy, although the disease can become chronic, with ensuing RPE decompensation. 2,3 Some patients, particularly older adults, 4 can develop choroidal neovascularization (CNV), which leads to a severe loss in visual acuity.…”