ACUTE MULTIFOCAL RETINITIS

PURPOSE: To describe the clinical presentation, ophthalmoscopic and fl uorescein angiographic findings, and natural history of 14 eyes in nin e otherwise healthy, young-to-middle-age adults with idiopathic, acute , multifocal retinitis. METHODS: A retrospective review of the clinica l and photographic records of nine patients. RESULTS: Five of the nine patients reported a flu-like illness 1 to 2 weeks before the onset of visual symptoms, Ophthalmoscopic findings included mild vitritis (11 of 14), mild optic nerve edema (seven of 14), macular star (two of 14) or localized neurosensory retinal detachment (two of 14) caused by ad jacent focus of retinitis, and small branch-artery occlusion (two of 1 4), Fluorescein angiography showed early blocking hypofluorescence wit h late Staining hyperfluorescence of all areas of retinitis. In patien ts with optic nerve edema, the disk showed late leakage. Specific test s for collagen vascular disorders, as well as systemic syphilis and to xoplasmosis titers, were negative in all patients, Five of six patient s with histories of cat exposure tested negative for systemic Bartonel la henselae antibodies, One patient with a history of cat exposure ref used testing, Clinical courses were self limited, with complete return of vision without treatment in all but: one eye, which developed a ju xtafoveal scar and localized traction retinal detachment in an area of pries retinitis.CONCLUSIONS: Idiopathic acute multifocal retinitis sh ould be considered in any otherwise healthy, young-to-middle age adult with acute loss of vision in the presence of multifocal retinitis, pa rticularly when accompanied by an antecedent flu like illness, Patient s with idiopathic acute multifocal retinitis usually have a favorable clinical course.