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Multifocal choroiditis and panuveitis (MCP) is an inflammatory disorder of unknown etiology, affecting the choroid, retina, and vitreous of the eye that presents asymmetrically, most often in young myopic women with photopsias, enlargement of the physiologic blind spot and decreased vision. [citation needed]
Unlike multiple evanescent white dot syndrome, multifocal choroiditis is a chronic disorder and macular scarring contributes to severe visual loss. Theories regarding the cause include an exogenous pathogen sensitizing an individual to antigens within photoreceptors, retinal pigment epithelium, or choroid. [2] [6]
Inflammation of these layers can lead to vision-threatening complications. If only the choroid is inflamed, not the retina, the condition is termed choroiditis. [1] The ophthalmologist's goal in treating these potentially blinding conditions is to eliminate the inflammation and minimize the potential risk of therapy to the patient.
Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an acquired inflammatory uveitis that belongs to the heterogenous group of white dot syndromes in which light-coloured (yellowish-white) lesions begin to form in the macular area of the retina.
A closely related condition is multifocal serpiginoid choroiditis. This is caused by tuberculosis. [3] The distinction between these two conditions is important as the latter responds to anti tuberculosis treatment while the former does not. Choroidal neovascularization (CNV) is the most common complication associated with Serpiginous choroiditis.
Punctate inner choroiditis (PIC) is an inflammatory choroiditis which occurs mainly in young women. Symptoms include blurred vision and scotomata. Yellow lesions are mainly present in the posterior pole and are between 100 and 300 micrometres in size. PIC is one of the so-called White Dot Syndromes.
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The diagnosis of VKH is based on the clinical presentation; the diagnostic differential is extensive, and includes sympathetic ophthalmia, sarcoidosis, primary intraocular B-cell lymphoma, posterior scleritis, uveal effusion syndrome, tuberculosis, syphilis, and multifocal choroidopathy syndromes. [3] [6]