Multifocal Choroiditis - Unknown etiology

A 51 year old woman presented with intermittent blurred vision in her left eye for a few months in 2003. At the time, her vision was 20/20 without treatment. The differential diagnosis was multiple evanescent white dot syndrome versus multifocal choroiditis. She was advised to return in 6 weeks but did not. In 2012, she had new symptoms of blind spots with flashes and floaters. Upon examination and testing, her scarring in the left eye had progressed. The right eye was uninvolved. She was diagnosed with multifocal choroiditis, an intraocular inflammatory condition with an unknown etiology. Fluorescein angiography of the left eye shows staining of extensive subretinal scarring that is more extensive than at the onset. Her left eye vision is still 20/20 after steroid treatment, but she has paracentral scotomas. She will begin immunomodulatory therapy for prevention of right eye involvement.