Jeannette Ossewaarde-van Norel1, Ninette Ten Dam-van Loon2, Joke H de Boer2, Aniki Rothova3. 1. Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: a.ossewaarde-vannorel@umcutrecht.nl. 2. Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands. 3. Department of Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands.
Abstract
PURPOSE: To report on the clinical manifestations, complications, and long-term visual prognosis of patients with peripheral multifocal chorioretinitis and to search for predictors for a lower visual outcome. DESIGN: Retrospective consecutive observational case series. METHODS: setting: Institutional. PATIENT POPULATION: 134 eyes in 69 patients with a minimum follow-up period of 5 years. OBSERVATION PROCEDURE: Clinical characteristics were recorded as well as the visual acuity (VA) at the onset of uveitis; after 1, 5, and 10 years; and at the end of the follow-up period. MAIN OUTCOME MEASURES: Visual acuity, clinical features and complications, required medications and surgeries. RESULTS: The majority of the patients were elderly women with chronic bilateral ocular involvement, who developed multiple ocular complications over time. Systemic sarcoidosis was present in 39% of patients. In addition to peripheral retinal lesions and vitritis, papillitis was present in 95% of cases. The major complications included macular edema (91%), cataract (93%), glaucoma (35%), and optic disc atrophy (25%). The treatment regimens included systemic corticosteroids and/or immunosuppressive drugs in 44% of patients, and 84% of patients required intraocular surgery. One third of the affected eyes developed VA <20/40 at 5-10 years of follow-up. VA at 1 year was the most important predictor of visual outcome at 5 and 10 years (P < .001). CONCLUSIONS: Peripheral multifocal chorioretinitis was associated with a high prevalence of cataract, macular edema, optic disc atrophy, and glaucoma. Despite the chronic course of the disease, multiple complications, and surgical interventions, the majority of patients achieved satisfactory long-term visual acuity.
PURPOSE: To report on the clinical manifestations, complications, and long-term visual prognosis of patients with peripheral multifocal chorioretinitis and to search for predictors for a lower visual outcome. DESIGN: Retrospective consecutive observational case series. METHODS: setting: Institutional. PATIENT POPULATION: 134 eyes in 69 patients with a minimum follow-up period of 5 years. OBSERVATION PROCEDURE: Clinical characteristics were recorded as well as the visual acuity (VA) at the onset of uveitis; after 1, 5, and 10 years; and at the end of the follow-up period. MAIN OUTCOME MEASURES: Visual acuity, clinical features and complications, required medications and surgeries. RESULTS: The majority of the patients were elderly women with chronic bilateral ocular involvement, who developed multiple ocular complications over time. Systemic sarcoidosis was present in 39% of patients. In addition to peripheral retinal lesions and vitritis, papillitis was present in 95% of cases. The major complications included macular edema (91%), cataract (93%), glaucoma (35%), and optic disc atrophy (25%). The treatment regimens included systemic corticosteroids and/or immunosuppressive drugs in 44% of patients, and 84% of patients required intraocular surgery. One third of the affected eyes developed VA <20/40 at 5-10 years of follow-up. VA at 1 year was the most important predictor of visual outcome at 5 and 10 years (P < .001). CONCLUSIONS: Peripheral multifocal chorioretinitis was associated with a high prevalence of cataract, macular edema, optic disc atrophy, and glaucoma. Despite the chronic course of the disease, multiple complications, and surgical interventions, the majority of patients achieved satisfactory long-term visual acuity.