Algorithm of Choroiditis

Abstract

Choroiditis may present as focal or multifocal lesions, and could be due to infectious or noninfectious etiology. Focal choroidal lesions are commonly caused by toxoplasma infection, tuberculosis, sarcoidosis or serpiginous choroiditis. Multifocal choroiditis can be due to infective etiology, such as tuberculosis, or any autoimmune choroiditis, such as ampiginous choroiditis or acute posterior multifocal placoid pigment epitheliopathy (APMPPE). Diffuse choroiditis may be correlated to panuveitis, such as Vogt-Koyanagi-Harada (VKH) syndrome or sympathetic ophthalmia. Other choroiditis may present as opportunistic infections in immunocompromised patients. Careful clinical examinations and tailored investigations would be helpful in making a prompt diagnosis of these different entities. Due to varied manifestations, diagnosis of choroiditis is challenging. This article will review the diagnostic approach of choroiditis based on clinical presentations, investigations and ancillary tests.