DOI: 10.25881/20728255_2023_18_4_S1_39

Authors

Doga A.V., Volodin P.L., Pedanova E.K., Poroshina M.A.

The S. Fyodorov Eye Microsurgery Federal State Institution, Moscow

Abstract

Rationale: A clinical case of idiopathic multifocal choroiditis, complicated by the bilateral inflammatory subretinal neovascular membrane is described. It was diagnosed after six months after the initial examination. Systemic therapy with glucocorticosteroids was started after six months after the diagnosis. Macrophage-like cells are presented for the first time during the idiopathic multifocal choroiditis.

Keywords: multifocal choroiditis, optical coherence tomography, myopic refraction, inflammatory subretinal neovascular membrane.

References

1. Dunlop AAS, Cree IA, Hage S, Luthert PJ, Lightman S. Multifocal choroiditis, clinicopathologic correlation. Arch Ophthalmol. 1998;116(6):801–803. doi: 10.1001/archopht.116.6.801.

2. Bloom SM, Snady-McCoy L. Multifocal choroiditis uveitis occurring after herpes zoster ophthalmicus. Am J Ophthalmol. 1989;108(6):733–735. doi: 10.1016/0002-9394(89)90873-8.

3. Chiquet C, Germain P, Burillon C, Coudry-Vergne PM, Paupert-Ravault M, Denis P. Multifocal choroiditis associated with herpes zoster ophthalmicus. Apropos of a case. J Fr Ophthalmol. 1996;19:712–715.

4. Bhende PS, Biswas J, Madhavan HN. Serological evidence for active Epstein-Barr virus infection in multifocal choroiditis. Indian J Pathol Microbiol. 1997; 40(2):129–131.

5. Borkar PP, Grassi MA. Unilateral multifocal choroiditis following EBV-positive mononucleoisis responsive to immunosuppression: a case report. BMC Ophthalmol. 2020;20(1):273. doi: 10.1186/s12886-020-01525-7.

6. Vandenbelt S, Shaikh S, Capone A, Jr, Williams GA. Multifocal choroiditis associated with West Nile virus encephalitis. Retina. 2003;23:97–99. doi: 10. 1097/00006982-200302000-00016.

7. Jimenez P, Kestelman E, Kestelman B, Gomes Vizzoni A, Cerbino-Nrto J, Land Curi AL. Multifocal choroiditis secondary to acute Zika virus infection. Ocul Immunol Inflamm. 2020;28:952–955. doi: 10.1080/09273948.2019.1651872.

8. Escott S, Tarabishi AD, Davidorf FH. Multifocal choroiditis following simultaneous hepatitis a, typhoid, and yellow fever vaccination. Clin Ophthalmol. 2013;7:363–365. doi: 10.2147/OPTH.S37443.

9. Mungmunpuntipantip R, Wiwanitkit V. COVID-19 vaccination and bilateral multifocal chroiditis. Ocul Immunol Inflamm. 2021;18:1. doi: 10.1080/09273948.2021.1968003.

10. Shimada H, Yuzawa M, Hirose T, Nakashizuka H, Hattori T, Kazato Y. Pathological findings of multifocal choroiditis with panuveitis and punctate inner choroidopathy. Jpn J Ophthalmol. 2008;52(4):282–288. doi: 10. 1007/s10384-008-0566-2.

11. Somkijrungroj T, Pearlman JA, Gonzales JA. Multifocal choroiditis and panuveitis presenting with progressive equatorial linear streaks: evolution of Schlaegel lines documented with multimodal imaging. Retin Cases Brief Rep. 2015;9(3):214–217. doi: 10.1097/ICB.0000000000000141.

12. Agarwal A, Invernizzi A, Singh RB, et al. An update on inflammatory choroidal neovascularization: epidemiology, multimodal imaging, and management. J Ophthalmic Inflamm Infect. 2018;8(1):13. Published 2018 Sep 12. doi:10.1186/s12348-018-0155-6

13. De Groot EL, ten Dam-van Loon NH, de Boer JH, Ossewaarde-van NJ. The efficacy of corticoid-sparing immunomodulatory therapy in treating patients with central multifocal choroiditis. Acta Ophthalmol. 2020;98:816–821. doi: 10.1111/aos.14473.

14. Hirooka K, Saito W, Hashimoto Y, Saito M, Ishida S. Increased macular choroidal blood flow velocity and decreased choroidal thickness with regression of punctate inner choroidopathy. BMC Ophthalmol. 2014;14:73. doi: 10.1186/ 1471-2415-14-73.

15. Neri P, Manoni M, Fortuna C, Lettieri M, Mariotti C, Giovannini A. Association of systemic steroids and mycophenolate mofetil as rescue therapy for uveitic choroidal neovascularization unresponsive to the traditional immunosuppressants: interventional case series. Int Ophthalmol. 2010;30(5):583–590. doi: 10.1007/s10792-009-9323-x.

16. Neri P, Pichi F, Pirani V, Arapi I. Systemic immunosuppression is highly effective in the long-term control of inflammatory non-infectious Uveitic choroidal neovascularization: a comparative study. Ocul Immunol Inflamm. 2020;7:1–5. doi: 10.1080/09273948.2020.1727530.

17. Vizualizaciya makrofagopodobnyh kletok setchatki s pomoshch’yu opticheskoj kogerentnoj tomografii u pacientov s sindromom mnozhestvennyh prohodyashchih belyh pyaten. Mal’cev DS, Kulikov AN, Burnasheva MA, Vasil’ev AS. Rossijskij obshchenacional’nyj oftal’mologicheskij forum. – 2022;1:155-156. (In Russ.)

18. Essex, R. W., Wong, J., Jampol, L. M., Dowler, J., & Bird, A. C. (2013). Idiopathic Multifocal Choroiditis. Retina, 33(1), 1–4. doi:10.1097/iae.0b013e31826418

19. Zhang, Xiongze; Zuo, Chengguo; Li, Meng; Chen, Hui; Huang, Shizhou; Wen, Feng (2013). Spectral-Domain Optical Coherence Tomographic Findings at Each Stage of Punctate Inner Choroidopathy. Ophthalmology, 120(12), 2678–2683. doi:10.1016/j.ophtha.2013.05.012

20. Standardization of Uveitis Nomenclature (SUN) Working Group. Classification Criteria for Multifocal Choroiditis With Panuveitis. Am J Ophthalmol. 2021 Aug;228:152-158. doi: 10.1016/j.ajo.2021.03.043. Epub 2021 May 11. PMID: 33845016; PMCID: PMC8559518

21. Rajesh A, Droho S, Lavine JA. Macrophages in close proximity to the vitreoretinal interface are potential biomarkers of inflammation during retinal vascular disease. J Neuroinflamm (2022) 19(1):203. doi: 10.1186/s12974-022-02562-3

For citation

Doga A.V., Volodin P.L., Pedanova E.K., Poroshina M.A. Difficulties in diagnosing of idiopathic multifocal choroiditis in a clinical case. Bulletin of Pirogov National Medical & Surgical Center. 2023;18(4,supplement):39-41. (In Russ.) https://doi.org/10.25881/20728255_2023_18_4_S1_39