title: Peripheral multifocal chorioretinitis: a distinct clinical entity?
abstract: OBJECTIVE
  The purpose of the study is to delineate the clinical features, complications, visual prognosis, and associated systemic diseases of peripheral multifocal chorioretinitis.
  
  
  METHODS
  The study design was a retrospective study.
  
  
  METHODS
  Of 828 patients with uveitis, 53 patients (6.4%) fulfilled all 3 of the following criteria: (1) the presence of multiple (>10), small, round, punched-out lesions in the peripheral retina; (2) the absence of central chorioretinal lesions; and (3) an associated intraocular inflammatory reaction.
  
  
  RESULTS
  The majority of patients were elderly white females with bilateral ocular involvement. The presenting symptoms consisted of vitreitis and/or iritis, papillitis, and numerous retinal punched-out lesions in the periphery. On initial examination, the complications included cystoid macular edema (CME) (48%), glaucoma (25%), and cataracts (19%), resulting in a mean visual acuity of 20/80. After more than 2 years of follow-up, CME was found in 72% and cataract in 62% of the affected eyes. Submacular neovascularization never developed. The final mean visual acuity was 20/60; this was mainly dependent on the presence of CME (eyes with CME; visual acuity was 20/80, eyes without CME; visual acuity was 20/50). In 25% of patients, an association with sarcoidosis was observed (histologic and radiologic diagnoses), and an additional 29% of patients had elevated serum angiotensin-converting enzyme levels.
  
  
  CONCLUSIONS
  Within the spectrum of multifocal chorioretinitis, the authors have defined a distinct clinical entity of peripheral multifocal chorioretinitis. The recognition of this clinical entity may be valuable because of its specific symptoms, prognosis, and association with sarcoidosis.
authors.affiliation: Department of Ophthalmology, F.C. Donders Institute, University Hospital Utrecht, The Netherlands.
authors.forename: C W
authors.initials: CW
authors.lastname: Lardenoye
authors.forename: A
authors.initials: A
authors.lastname: Van der Lelij
authors.forename: W S
authors.initials: WS
authors.lastname: de Loos
authors.forename: W F
authors.initials: WF
authors.lastname: Treffers
authors.forename: A
authors.initials: A
authors.lastname: Rothova
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002825:Chorioretinitis / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D005901:Glaucoma / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008269:Macular Edema / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology