Abstract
Abstract: :
Purpose: To analyze the overlap in demographics, clinical presentation, course and treatment of Multifocal Choroiditis (MFC) /Punctate Inner Choroidopathy (PIC) and Acute Zonal Occult Outer Retinopathy (AZOOR). Methods: This is a retrospective analysis of 34 patients diagnosed with PIC or MFC over the last 20 years, that was compared with similar data on 51 patients with AZOOR.Results: 88% of the PIC/MFC group and 91% of the AZOOR group occur in Caucasions. There is a strong female predilection: 88% in PIC/MFC vs. 73% in AZOOR. 28% of PIC/MFC patients were also diagnosed with AZOOR. There is a high incidence of autoimmune diseases in PIC/MFC (23%) and AZOOR (28%) patients. Disease onset during or immediately after a pregnancy was 14.7% in PIC/MFC and 10% in AZOOR patients. There was unilateral eye involvement at the onset in 68% of the PIC/MFC group and 61% of the AZOOR group. At the final follow–up there was bilateral disease in 76% of both the PIC/MFC and AZOOR groups. Visual acuity at final examination was better or equal to 20/40 in 60% of the patients with PIC/MFC after an average follow–up of 51 months, and 68 % of the AZOOR group after an average of 96 months. Vitritis was common in both the MFC (66.67%) and AZOOR (57%) groups. When AZOOR overlapped with MFC, the incidence of vitritis increased to 71.43%. 40% of the eyes with PIC/MFC had recurrent disease vs. 31.3% of the AZOOR patients. The electroretinogragram (ERG) was abnormal in AZOOR patients (100% by definition) and PIC/MFC group (80%). Most patients in the PIC/MFC group stabilized between 2 weeks and 6 months after onset. The percent of patients with improved visual outcome dropped from 44% to 13% in the PIC group and from 45% to 14% in the MFC group when there was overlap with AZOOR.Conclusions: PIC/MFC and AZOOR show significant overlap in patient characteristics, symptoms and clinical course. The most prominent similarities include race, sex, proximity to pregnancy, incidence of autoimmune disease, presence of vitritis and ERG abnormalities. Therefore the authors suggest that PIC/MFC/AZOOR are spectrum of the same disease.
Keywords: chorioretinitis • inflammation • neovascularization