ENLARGED BLIND SPOTS IN CHORIORETINAL INFLAMMATORY DISORDERS

Purpose: This study was undertaken to better characterize patients wit h multifocal choroiditis and panuveitis (MCP), punctate inner choroido pathy (PIG), multiple evanescent white dot syndrome (MEWDS), and diffu se subretinal fibrosis syndrome. The specific aim was to determine whe ther these disorders were different entities or part of a spectrum of diseases with similar features. Methods: Seventy-nine patients were in cluded in the study. Most of the patients have been followed up prospe ctively since July 1980 with some found retrospectively. Results: Fort y-one patients had MCP, 16 had PIG, 6 had diffuse subretinal fibrosis syndrome, and 16 had MEWDS. Patients with MCP had visual loss and visu al field defects caused directly by visible lesions or recurrent infla mmation around old lesions. In particular, clustering of lesions aroun d the optic nerve and nasal periphery was seen in patients with MCP an d appeared to be related to visual field loss. Patients with PIC also had enlarged blind spots and other field defects explained by fundus l esions. Patients with PIC and MCP did not have recurrent lesions on ex tended follow-up. Patients with diffuse subretinal fibrosis syndrome r epresented a subset of patients characterized with lesions in the post erior pole, severe scarring, and visual loss. Patients with MEWDS had the least inflammation with symmetrically distributed lesions. Minimal permanent chorioretinal scarring was seen in patients with MEWDS. Vis ual field defects improved in most patients with MEWDS and PIG, wherea s most patients with MCP and diffuse subretinal fibrosis syndrome did not improve. Conclusions: Although enlarged blind spots are a feature of all four disorders, other clinical, angiographic, and electroretino graphic evidence suggest that these are different entities.