VISUAL PROGNOSIS OF MULTIFOCAL CHOROIDITIS, PUNCTATE INNER CHOROIDOPATHY, AND THE DIFFUSE SUBRETINAL FIBROSIS SYNDROME

Purpose: To characterize the visual prognosis of patients with multifo cal choroiditis and panuveitis (MCP), punctate inner choroidopathy (PI C), and the diffuse subretinal fibrosis (DSF) syndrome. Methods: Forty -one patients with MCP, 16 with PIC, and 5 with DSF syndrome were eval uated. The mean follow-up was approximately 39 months for patients wit h MCP, 51 months for patients with PIC, and 59 months for patients wit h DSF syndrome. Complete ophthalmic examinations were performed, and p hotofiles were reviewed. Results: The final average visual acuity for patients with MCP was 20/50. Forty-five of the 68 involved eyes (66%) had 20/40 visual acuity or better. Choroidal neovascularization (CNV) developed within choroiditis lesions in 22 (19 patients) of 68 eyes, c ausing visual acuity poorer than 20/50 in 14 eyes. The final average v isual acuity in patients with PIC was 20/39; 23 (77%) of the 30 involv ed eyes had visual acuity of 20/40 or better. Six of the seven eyes wi th 20/50 or poorer vision had CNV. Six other eyes had CNV within the m acula that regressed spontaneously with good resultant vision. Seven o f the ten involved eyes with DSF syndrome had 20/200 or poorer vision. Poor vision was due to fibrosis and atrophy within the macula. Conclu sion: Most patients with MCP and PIC retained visual acuity of 20/40 o r better. In nearly one third of patients with MCP and PIC, CNV develo ped, Severe visual loss in these diseases was usually due to subfoveal CNV. Patients with DSF syndrome had a poor prognosis due to fibrosis and atrophy involving the macula.