Long-term visual prognosis of peripheral multifocal chorioretinitis.

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.