Multifocal choroïditis: is it a granulomatosis close to sarcoidosis?

Abstract

AbstractPurpose Multifocal choroiditis is an idiopathic posterior uveitis. It combines small white spots in fundus of eye and recurrent intraocular inflammation. Some biological or radiological manifestations of sarcoidosis may be found in these patients.Methods We report a case of severe multifocal choroiditis associated with systemic granulomatosis. The aim of our study was to describe the clinical and therapeutic aspects, and discuss the etiopathogenic approach of this rare entity.Results A 45 years old women who consults for blurred vision. Visual acuity is reduced at 1/20 P8 in right eye and 3/10 P5 in the left. There is a hyalite + bilaterally. Peri papillary atrophy, hemorrhage around the macula, multiple white and pigmentis small spots was found in fundus of eyes. Retinal thickening and involvements of the pigment epithelium and choroid are revealed by macular OCT in the right eye. The fluorescein angiography show hypofluorescence of chorioretinal spots in early time, a window effect scarring and bilateral papillitis. The ECA is 74 UECA. Chest scan reveal a non specific parenchymal micronodules. The patient received systemic corticosteroids. Control OCT show a subretinal fibrosis explaining the introduction of immunosuppressant treatment. The final visual acuity is 1/10 right and 12/10 left with a decline of 3 years.Conclusion Although intraocular manifestations of multifocal choroiditis, it most correspond to a systemic granulomatosis near sarcoidosis.