Peripheral multifocal chorioretinitis: complications, prognosis and relation with sarcoidosis

Acta Ophthalmol. 2013 Sep;91(6):492-7. doi: 10.1111/j.1755-3768.2012.02483.x. Epub 2012 Aug 3.

Abstract

Purpose: To investigate the prognosis and complications in patients with peripheral multifocal chorioretinitis (PMC). PMC is a posterior or panuveitis characterized by chronic bilateral vitritis and punched-out lesions in the peripheral retina which occurs commonly in elderly white women and is associated with sarcoidosis. Prognosis and complications are largely unknown.

Methods: A structured literature search in PubMed, Embase and Cochrane was performed to identify relevant articles. Articles were screened, and the remaining articles were critically appraised based on relevance and validity.

Results: The search yielded 267 articles. Eight relevant articles were retrieved. All studies reported on moderate visual impairment. Macular oedema occurred in 60% of the patients with PMC (range, 0-71%), glaucoma in 27% (range, 25-43%) and an epiretinal membrane in 21% (range, 0-28%). In total, 47% had proven or presumed sarcoidosis. Treatment usually comprised topical corticosteroids, periocular steroid injections and systemic corticosteroids regularly in combination with methotrexate.

Conclusion: The prognosis of patients with PMC is characterized by a rather poor visual outcome and the relatively high prevalence of complications. PMC is strongly associated with sarcoidosis. Solid proof for the treatment efficacy of PMC is lacking.

Keywords: chronic posterior uveitis; cystoid macular oedema; peripheral multifocal chorioretinitis; punched-out lesions; sarcoidosis.

Publication types

  • Review

MeSH terms

  • Chorioretinitis / complications*
  • Chorioretinitis / diagnosis
  • Chorioretinitis / drug therapy
  • Drug Therapy, Combination
  • Epiretinal Membrane / diagnosis
  • Glaucoma / diagnosis
  • Glucocorticoids / therapeutic use
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Macular Edema / diagnosis
  • Methotrexate / therapeutic use
  • Prognosis
  • Sarcoidosis / complications*
  • Sarcoidosis / diagnosis
  • Sarcoidosis / drug therapy

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Methotrexate