Multifocal Choroiditis - 15-year follow-up

This is a 15 year follow up of a 50-year-old male patient with multifocal choroiditis and panuveitis (MFC) with irregular treatment and follow-up. In 2004 there was bilateral vitritis (note the hazy media) but no retinal pigment epithelial scarring. Periocular triamcinolone injections were given. The patient developed peripapillary choroidal neovascularization treated with laser photocoagulation (the black scar in the 2006 photos). The left eye has developed some peripapillary pigmentary scarring (turquoise arrow). He was lost to follow-up for years. By 2019, many more pigmented RPE scars had developed OU (yellow arrows). The peripapillary RPE scarring in the left eye had progressed (teal arrow, 2019 photo). The OCT from 2019 showed intraretinal cysts (red arrows). The white arrow showed a hypertrophic scar. Multifocal choroiditis is a condition of unknown etiology suspected to be an auto-immune disorder. Corticosteroids and immune modulating drugs such as methotrexate and azathioprine are used to treat the inflammatory response, and were used intermittently in this patient’s case. Poor adherence with treatment was associated with the progressive disease demonstrated in this case.