Idiopathic multifocal choroiditis with outer retinal or chorioretinal atrophy

Jesse J. Jung, Samira Khan, Sarah Mrejen, Roberto Gallego-Pinazo, Emmett T. Cunningham, K. Bailey Freund, Lee M. Jampol, Lawrence A. Yannuzzi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

PURPOSE: To report thirteen cases of idiopathic multifocal choroiditis with discrete chorioretinal lesions who were found to have zonal, multizonal, or diffuse outer retinal or chorioretinal atrophy. METHODS: A retrospective observational case series using multimodal imaging including high-definition optical coherence tomography, fundus autofluorescence imaging, and fluorescein and indocyanine green angiography. RESULTS: Twenty-one eyes in 13 patients with idiopathic multifocal choroiditis were found to have zonal, multizonal, or diffuse outer retinal or chorioretinal atrophy visualized using multimodal imaging. Thirteen eyes presented with diffuse disease, six eyes with multizonal, and two with zonal atrophy. Patterns of atrophy included zones surrounding the optic nerve, multiple geographic zones in the mid and far periphery, and a diffuse peripheral pattern with relative sparing of the central macula until later in the course of disease. Eleven of the 13 patients were treated with topical, periocular, or systemic corticosteroids, and 1 patient was also treated with systemic immunomodulatory treatment. The atrophic changes progressed over an average of 8 years of follow-up in 10 eyes despite therapy. CONCLUSION: Idiopathic multifocal choroiditis can present with an uncommon pattern of zonal, multizonal, or diffuse outer retinal or chorioretinal atrophy as part of its clinical spectrum. The severity, extent, and progression of these atrophic changes are best appreciated using multimodal diagnostic imaging.

Original languageEnglish (US)
Pages (from-to)1439-1450
Number of pages12
JournalRetina
Volume34
Issue number7
DOIs
StatePublished - Jul 2014

Keywords

  • AZOOR
  • chorioretinal atrophy
  • idiopathic multifocal choroiditis
  • multimodal imaging
  • outer retinal atrophy

ASJC Scopus subject areas

  • Ophthalmology

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