title: Course of disease in multifocal choroiditis lacking sufficient immunosuppression: a case report.
abstract: BACKGROUND
  Multifocal choroiditis with panuveitis is a rare disease. The educational merit of this case presentation results from the good documentation and the impressive ocular fundus pictures.
  
  
  METHODS
  We illustrate the 3-year course of disease in a 22-year-old myopic white woman with multifocal choroiditis with panuveitis and secondary choroidal neovascularization. The activity of the disease was evaluated clinically by optical coherence tomography and fluorescein angiography. Choroidal neovascularization was treated by intravitreal bevacizumab (2.5 mg/0.1 ml). Our patient lacked systemic therapy for the first 11 months because of noncompliance.
  
  
  CONCLUSIONS
  The case is remarkable as the delayed onset of peripheral lesions and the additional existence of high myopia made diagnosis difficult. In addition, it demonstrates that full outbreak of disease with multiple central and peripheral fundus lesions and secondary choroidal neovascularization can develop without systemic treatment.
authors: Department of Ophthalmology, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany. katharina.schroeder@med.uni-duesseldorf.de.
authors: Katharina
authors: K
authors: Schroeder
authors: Department of Ophthalmology, University of Wuerzburg, Wuerzburg, Germany.
authors: Tobias
authors: T
authors: Meyer-Ter-Vehn
authors: Department of Ophthalmology, Stadtspital Triemli, Zürich, Switzerland.
authors: Heidi
authors: H
authors: Fassnacht-Riederle
authors: Department of Ophthalmology, University of Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
authors: Rainer
authors: R
authors: Guthoff
mesh_terms: D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000008:administration & dosage*; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D002833:Choroiditis / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D016572:Cyclosporine / Q000008:administration & dosage*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D058449:Intravitreal Injections; D000080364:Multifocal Choroiditis; D011239:Prednisolone / Q000008:administration & dosage*; D035583:Rare Diseases; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; D000068258:Bevacizumab; D016572:Cyclosporine; D011239:Prednisolone
keywords: Bevacizumab; Case report; Chorioretinal lesions; Multifocal choroiditis; Secondary CNV; Systemic immunosuppression