Prevalence of Outer Retinal Atrophy in Idiopathic Multifocal Choroiditis Associated with Persistent Fundus Hyperautofluorescence

Abstract

Purpose : To describe the prevalence and anatomic correlates for an uncommon variant of idiopathic multifocal choroiditis (MFC) characterized by regions of hyperautofluorescence showing minimal change over an extended follow-up.

Methods : Retrospective review of MFC patients from a single retina practice. Fluorescein angiography, indocyanine green angiography, optical coherence tomography, fundus autofluorescence and ultra-widefield imaging data were reviewed. The spatial and temporal characteristics of outer retinal and chorioretinal lesions were evaluated.

Results : Fifty-five eyes from 34 patients with a mean follow-up period of 4.6 years were analyzed. All eyes demonstrated pigmented, punched-out chorioretinal scars, with additional findings including peripheral curvilinear scars, vitritis and choroidal neovascularization. In addition, 5 eyes (9.1%) demonstrated a persistent fundus autofluorescence pattern characterized by regions of fundus hyperautofluorescence occurring in the posterior pole and/or periphery. In these 5 eyes, both visual acuity and the intensity and size of these hyperautofluorescent showed minimal change over an extended follow-up. Correlation of multimodal imaging data showed that the regions of hyperautofluorescence correlated with structural changes in the outer retina, without observable alterations at the level of the choroid or retinal pigment epithelium.

Conclusions : This study reports the prevalence and multimodal imaging characteristics of a rare variant of idiopathic MFC. These findings expand our understanding of the range clinical features occurring in this disorder.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.