Department of Ophthalmology & Vision Science, University of California, Davis, Sacramento, California.
Department of Ophthalmology, Northwest Permanente, Portland, Oregon.
Retina. 2022 Aug 1;42(8):1574-1582. doi: 10.1097/IAE.0000000000003481.
To report nine cases of multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy.
A retrospective observational case series of eyes with multifocal choroiditis with serpiginous-like peripapillary chorioretinal atrophy. Multimodal imaging findings were reviewed and presented.
Fifteen eyes of 9 patients (6 women and 3 men), with a mean age of 48.1 years (median, 46 years; range, 23-74 years), presented with multifocal choroiditis serpiginous-like peripapillary chorioretinal atrophy. All 15 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 elevations on optical coherence tomography, 10 eyes (66.7%) had mild vitritis, and 4 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.
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 retinal pigment epithelium elevated on optical coherence tomography and peripheral curvilinear streak lesions.
报告 9 例多灶性脉络膜炎伴匐行性周边性脉络膜视网膜萎缩。
回顾性观察性病例系列研究了 9 例（6 名女性和 3 名男性）多灶性脉络膜炎伴匐行性周边性脉络膜视网膜萎缩患者的眼睛。回顾并呈现了多模态成像发现。
9 例患者的 15 只眼（6 名女性和 3 名男性），平均年龄 48.1 岁（中位数为 46 岁；范围，23-74 岁），表现为多灶性脉络膜炎匐行性周边性脉络膜视网膜萎缩。所有 15 只眼均出现匐行性周边改变，在眼底后极部或周边有离散的萎缩斑或穿凿性瘢痕。11 只眼（73.3%）在光学相干断层扫描上有锥形视网膜色素上皮抬高，10 只眼（66.7%）有轻度玻璃体炎症，4 只眼（26.7%）有周边曲线状条纹病变。3 只眼（20%）有脉络膜新生血管。所有患者均对全身免疫抑制、局部皮质类固醇注射和/或玻璃体内抗血管内皮生长因子注射治疗反应良好。
多灶性脉络膜炎除了在后极部或周边有典型的萎缩斑或穿凿性瘢痕、锥形视网膜色素上皮抬高和周边曲线状条纹病变外，还可能出现类似匐行性脉络膜炎的周边性脉络膜视网膜改变。
