*Vitreous-Retina-Macula Consultants of New York, New York, New York; †LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute, New York, New York; ‡Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical College, New York, New York; §Department of Medicine, California Pacific Medical Center, San Francisco, California; ¶Department of Ophthalmology, Stanford University School of Medicine, Stanford, California; and **West Coast Retina Medical Group, San Francisco, California.
Retina. 2014 Jan;34(1):98-107. doi: 10.1097/IAE.0b013e31829234cb.
To describe the clinical characteristics and progression of patients with multifocal choroiditis lesions who had minimal or no evidence of anterior uveitis and/or vitritis.
Retrospective, observational, single-center consecutive case series. Clinical histories, examination, and multimodal imaging findings were analyzed.
Sixty-five eyes of 41 patients were identified. The mean age at diagnosis was 38.4 years (median, 35 years; range, 15-81 years), and 70.7% of the patients were women. Involvement was bilateral in 21 patients (51.2%) at presentation. The 60-month bilateral event-free survival was 75.0% (95% confidence interval, 49.8-91.2%). The mean visual acuity was 20/46 (median, 20/25; range, 20/20 to count fingers at 2 feet) at presentation and 20/42 (median, 20/25; range, 20/20-5/400) at the last recorded visit. The 60-month "20/50 or worse" event-free survival was 100%. Between the first presentation and final follow-up (a mean duration of 92.6 months; range, 0-343 months), 46.7% of the eyes developed new or larger chorioretinal spots and 32.6% developed new or recurrent choroidal neovascularization. The 60-month choroidal neovascularization event-free survival was 68.1% (95% confidence interval, 39.2-85.4%).
Patients with multifocal choroiditis lesions, but with minimal or no anterior uveitis or vitritis, tended to be young women. Approximately half of the patients presented with bilateral involvement, which is less than has been reported in most case series of multifocal choroiditis with panuveitis. One quarter of all unilaterally affected patients will develop bilateral involvement by 60 months.
描述患有多发性脉络膜炎病变但仅有轻微或无前部葡萄膜炎和/或玻璃体炎症证据的患者的临床特征和进展。
回顾性、观察性、单中心连续病例系列。分析临床病史、检查和多模态成像结果。
共确定 41 例患者的 65 只眼。诊断时的平均年龄为 38.4 岁（中位数为 35 岁；范围，15-81 岁），70.7%的患者为女性。21 例患者（51.2%）在就诊时为双侧受累。60 个月双侧无事件生存率为 75.0%（95%置信区间，49.8-91.2%）。就诊时的平均视力为 20/46（中位数，20/25；范围，20/20 至 2 英尺处能数指），最后一次记录时的视力为 20/42（中位数，20/25；范围，20/20-5/400）。60 个月“20/50 或更差”无事件生存率为 100%。在首次就诊和最终随访之间（平均随访时间为 92.6 个月；范围，0-343 个月），46.7%的眼出现新的或更大的脉络膜视网膜病灶，32.6%出现新的或复发性脉络膜新生血管形成。60 个月脉络膜新生血管无事件生存率为 68.1%（95%置信区间，39.2-85.4%）。
患有多发性脉络膜炎病变但仅有轻微或无前部葡萄膜炎或玻璃体炎症的患者往往是年轻女性。约一半的患者就诊时为双侧受累，这比大多数伴有全葡萄膜炎的多发性脉络膜炎病例系列报道的要少。所有单侧受累患者中有四分之一将在 60 个月内发展为双侧受累。
