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Multifocal Choroiditis and Panuveitis

  • Eun Young Choi
  • Min Kim
Chapter
Part of the Retina Atlas book series (RA)

Abstract

Multifocal choroiditis and panuveitis (MCP) is an idiopathic chorioretinal inflammatory disease. Prominent vitritis and anterior segment uveitis are commonly observed. The acute inner chorioretinal lesions subsequently evolve into pigmented scars and may lead to the development of choroidal neovascularization (CNV). The clinical, diagnostic and treatment aspects of MCP are discussed based on multimodal imaging results with the reviews of the current medical literature.

References

  1. Amer R, Priel E, Kramer M. Spectral-domain optical coherence tomographic features of choroidal neovascular membranes in multifocal choroiditis and punctate inner choroidopathy. Graefes Arch Clin Exp Ophthalmol. 2015;253(6):949–57.CrossRefGoogle Scholar
  2. Brown DM, Michels M, Kaiser PK, et al. Ranibizumab versus verteporfin photodynamic therapy for neovascular age-related macular degeneration: two-year results of the ANCHOR study. Ophthalmology. 2009;116(1):57–65 e55.CrossRefGoogle Scholar
  3. Brown J Jr, Folk JC. Retina-vitreous-macula. Philadelphia: WB Saunders; 1999.Google Scholar
  4. Brown J Jr, Folk JC, Reddy CV, et al. Visual prognosis of multifocal choroiditis, punctate inner choroidopathy, and the diffuse subretinal fibrosis syndrome. Ophthalmology. 1996;103(7):1100–5.CrossRefGoogle Scholar
  5. Callanan D, Gass JD. Multifocal choroiditis and choroidal neovascularization associated with the multiple evanescent white dot and acute idiopathic blind spot enlargement syndrome. Ophthalmology. 1992;99(11):1678–85.CrossRefGoogle Scholar
  6. Cantrill HL, Folk JC. Multifocal choroiditis associated with progressive subretinal fibrosis. Am J Ophthalmol. 1986;101(2):170–80.CrossRefGoogle Scholar
  7. Chang LK, Spaide RF, Brue C, et al. Bevacizumab treatment for subfoveal choroidal neovascularization from causes other than age-related macular degeneration. Arch Ophthalmol. 2008;126(7):941–5.CrossRefGoogle Scholar
  8. Curcio CA, Sloan KR, Kalina RE, et al. Human photoreceptor topography. J Comp Neurol. 1990;292(4):497–523.CrossRefGoogle Scholar
  9. Doran RM, Hamilton AM. Disciform macular degeneration in young adults. Trans Ophthalmol Soc U K. 1982;102(Pt 4):471–80.PubMedGoogle Scholar
  10. Dreyer RF, Gass DJ. Multifocal choroiditis and panuveitis. A syndrome that mimics ocular histoplasmosis. Arch Ophthalmol. 1984;102(12):1776–84.CrossRefGoogle Scholar
  11. Dunlop AA, Cree IA, Hague S, et al. Multifocal choroiditis: clinicopathologic correlation. Arch Ophthalmol. 1998;116(6):801–3.CrossRefGoogle Scholar
  12. Essex RW, Wong J, Jampol LM, et al. Idiopathic multifocal choroiditis: a comment on present and past nomenclature. Retina. 2013;33(1):1–4.CrossRefGoogle Scholar
  13. Fine HF, Zhitomirsky I, Freund KB, et al. Bevacizumab (avastin) and ranibizumab (lucentis) for choroidal neovascularization in multifocal choroiditis. Retina. 2009;29(1):8–12.CrossRefGoogle Scholar
  14. Frau E, Dussaix E, Offret H, et al. The possible role of herpes viruses in multifocal choroiditis and panuveitis. Int Ophthalmol. 1990;14(5–6):365–9.CrossRefGoogle Scholar
  15. Fung AT, Pal S, Yannuzzi NA, et al. Multifocal choroiditis without panuveitis: clinical characteristics and progression. Retina. 2014;34(1):98–107.CrossRefGoogle Scholar
  16. Giansanti F, Eandi CM, Virgili G. Submacular surgery for choroidal neovascularisation secondary to age-related macular degeneration. Cochrane Database Syst Rev. 2009;(2):CD006931.  https://doi.org/10.1002/14651858.CD006931.pub2.
  17. Grutzmacher RD, Henderson D, McDonald PJ, et al. Herpes simplex chorioretinitis in a healthy adult. Am J Ophthalmol. 1983;96(6):788–96.CrossRefGoogle Scholar
  18. Haen SP, Spaide RF. Fundus autofluorescence in multifocal choroiditis and panuveitis. Am J Ophthalmol. 2008;145(5):847–53.CrossRefGoogle Scholar
  19. Hawkins BS, Bressler NM, Bressler SB, et al. Surgical removal vs observation for subfoveal choroidal neovascularization, either associated with the ocular histoplasmosis syndrome or idiopathic: I. Ophthalmic findings from a randomized clinical trial: Submacular Surgery Trials (SST) Group H Trial: SST Report No. 9. Arch Ophthalmol. 2004;122(11):1597–611.CrossRefGoogle Scholar
  20. Hayreh SS. Segmental nature of the choroidal vasculature. Br J Ophthalmol. 1975;59(11):631–48.CrossRefGoogle Scholar
  21. Jabs DA, Rosenbaum JT, Foster CS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol. 2000;130(4):492–513.CrossRefGoogle Scholar
  22. Jampol LM, Sieving PA, Pugh D, et al. Multiple evanescent white dot syndrome. I. Clinical findings. Arch Ophthalmol. 1984;102(5):671–4.CrossRefGoogle Scholar
  23. Jampol LM, Becker KG. White spot syndromes of the retina: a hypothesis based on the common genetic hypothesis of autoimmune/inflammatory disease. Am J Ophthalmol. 2003;135(3):376–9.CrossRefGoogle Scholar
  24. Joondeph BC, Tessler HH. Multifocal choroiditis. Int Ophthalmol Clin. 1990;30(4):286–90.CrossRefGoogle Scholar
  25. Kedhar SR, Thorne JE, Wittenberg S, et al. Multifocal choroiditis with panuveitis and punctate inner choroidopathy: comparison of clinical characteristics at presentation. Retina. 2007;27(9):1174–9.CrossRefGoogle Scholar
  26. Khorram KD, Jampol LM, Rosenberg MA. Blind spot enlargement as a manifestation of multifocal choroiditis. Arch Ophthalmol. 1991;109(10):1403–7.CrossRefGoogle Scholar
  27. Levison AL, Baynes KM, Lowder CY, et al. Choroidal neovascularisation on optical coherence tomography angiography in punctate inner choroidopathy and multifocal choroiditis. Br J Ophthalmol. 2017;101(5):616–22.CrossRefGoogle Scholar
  28. Mateo-Montoya A, Baglivo E, de Smet MD. Intravitreal methotrexate for the treatment of choroidal neovascularization in multifocal choroiditis. Eye (Lond). 2013;27(2):277–8.CrossRefGoogle Scholar
  29. Michel SS, Ekong A, Baltatzis S, et al. Multifocal choroiditis and panuveitis: immunomodulatory therapy. Ophthalmology. 2002;109(2):378–83.CrossRefGoogle Scholar
  30. Morgan CM, Schatz H. Recurrent multifocal choroiditis. Ophthalmology. 1986;93(9):1138–47.CrossRefGoogle Scholar
  31. Nolle B, Eckardt C. Vitrectomy in multifocal chorioretinitis. Ger J Ophthalmol. 1993;2(1):14–9.PubMedGoogle Scholar
  32. Nolle B, Faul S, Jenisch S, et al. Peripheral multifocal chorioretinitis with panuveitis: clinical and immunogenetic characterization in older patients. Graefes Arch Clin Exp Ophthalmol. 1998;236(6):451–60.CrossRefGoogle Scholar
  33. Nozik RA, Dorsch W. A new chorioretinopathy associated with anterior uveitis. Am J Ophthalmol. 1973;76(5):758–62.CrossRefGoogle Scholar
  34. Nussenblatt RB, Whitcup SM, Palestine AG. Fundamentals clinical practice. 2nd ed. St. Louis: Mosby Year-Book; 1996.Google Scholar
  35. Parodi MB, Di Crecchio L, Lanzetta P, et al. Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization associated with multifocal choroiditis. Am J Ophthalmol. 2004;138(2):263–9.CrossRefGoogle Scholar
  36. Pearlman RB, Golchet PR, Feldmann MG, et al. Increased prevalence of autoimmunity in patients with white spot syndromes and their family members. Arch Ophthalmol. 2009;127(7):869–74.CrossRefGoogle Scholar
  37. Quillen DA, Davis JB, Gottlieb JL, et al. The white dot syndromes. Am J Ophthalmol. 2004;137(3):538–50.CrossRefGoogle Scholar
  38. Raven ML, Ringeisen AL, Yonekawa Y, et al. Multi-modal imaging and anatomic classification of the white dot syndromes. Int J Retina Vitreous. 2017;3:12.CrossRefGoogle Scholar
  39. Reddy CV, Brown J Jr, Folk JC, et al. Enlarged blind spots in chorioretinal inflammatory disorders. Ophthalmology. 1996;103(4):606–17.CrossRefGoogle Scholar
  40. Shimada H, Yuzawa M, Hirose T, et al. Pathological findings of multifocal choroiditis with panuveitis and punctate inner choroidopathy. Jpn J Ophthalmol. 2008;52(4):282–8.CrossRefGoogle Scholar
  41. Slakter JS, Giovannini A, Yannuzzi LA, et al. Indocyanine green angiography of multifocal choroiditis. Ophthalmology. 1997;104(11):1813–9.CrossRefGoogle Scholar
  42. Spaide RF, Sugin S, Yannuzzi LA, et al. Epstein-Barr virus antibodies in multifocal choroiditis and panuveitis. Am J Ophthalmol. 1991a;112(4):410–3.CrossRefGoogle Scholar
  43. Spaide RF, Yannuzzi LA, Freund KB. Linear streaks in multifocal choroiditis and panuveitis. Retina. 1991b;11(2):229–31.CrossRefGoogle Scholar
  44. Spaide RF, Koizumi H, Freund KB. Photoreceptor outer segment abnormalities as a cause of blind spot enlargement in acute zonal occult outer retinopathy-complex diseases. Am J Ophthalmol. 2008;146(1):111–20.CrossRefGoogle Scholar
  45. Thorne JE, Wittenberg S, Jabs DA, et al. Multifocal choroiditis with panuveitis incidence of ocular complications and of loss of visual acuity. Ophthalmology. 2006;113(12):2310–6.CrossRefGoogle Scholar
  46. Tiedeman JS. Epstein-Barr viral antibodies in multifocal choroiditis and panuveitis. Am J Ophthalmol. 1987;103(5):659–63.CrossRefGoogle Scholar
  47. Vance SK, Khan S, Klancnik JM, et al. Characteristic spectral-domain optical coherence tomography findings of multifocal choroiditis. Retina. 2011;31(4):717–23.CrossRefGoogle Scholar
  48. Watzke RC, Packer AJ, Folk JC, et al. Punctate inner choroidopathy. Am J Ophthalmol. 1984;98(5):572–84.CrossRefGoogle Scholar
  49. Yasuno Y, Okamoto F, Kawana K, et al. Investigation of multifocal choroiditis with panuveitis by three-dimensional high-penetration optical coherence tomography. J Biophotonics. 2009;2(6–7):435–41.CrossRefGoogle Scholar
  50. Yeh S, Forooghian F, Wong WT, et al. Fundus autofluorescence imaging of the white dot syndromes. Arch Ophthalmol. 2010;128(1):46–56.CrossRefGoogle Scholar
  51. Zahid S, Chen KC, Jung JJ, et al. Optical coherence tomography angiography of chorioretinal lesions due to idiopathic multifocal choroiditis. Retina. 2017;37(8):1451–63.  https://doi.org/10.1097/IAE.0000000000001381.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Eun Young Choi
    • 1
  • Min Kim
    • 1
  1. 1.Department of OphthalmologyGangnam Severance Hospital, Yonsei University College of MedicineSeoulSouth Korea

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