Idiopathic multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy.

Moussa, Kareem; Alsberge, Joseph B; Munk, Marion R; Vora, Robin A; Emami-Naeini, Parisa; Yiu, Glenn; Cunningham, Emmett T (2022). Idiopathic multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy. Retina, 42(8), pp. 1574-1582. Wolters Kluwer 10.1097/IAE.0000000000003481

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PURPOSE

To report nine cases of multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy.

METHODS

A retrospective observational case series of eyes with multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy. Multimodal imaging findings were reviewed and presented.

RESULTS

Fifteen eyes of 9 patients (6 women and 3 men), mean age 48.1 years (median 46 years, range 23-74 years), presented with multifocal choroiditis serpiginous-like peripapillary chorioretinal atrophy. All fifteen eyes presented with serpiginoid peripapillary changes and had discrete patches of atrophy or punched out scars in the posterior pole or periphery. Eleven eyes (73.3%) had cone-shaped retinal pigment epithelium (RPE) elevations on optical coherence tomography (OCT), 10 eyes (66.7%) had mild vitritis, and four eyes (26.7%) had peripheral curvilinear streak lesions. Three eyes (20%) had choroidal neovascularization. All patients responded well to treatment with systemic immunosuppression, local corticosteroid injections, and/or intravitreal anti-vascular endothelial growth factor injections.

CONCLUSION

Multifocal choroiditis may present with peripapillary chorioretinal changes resembling a serpiginous-like choroiditis in addition to the classic findings of patches of atrophy or punched-out scars in the posterior pole or periphery, cone-shaped RPE elevated on optical coherence tomography, and peripheral curvilinear streak lesions.

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