J Korean Ophthalmol Soc.  2020 Dec;61(12):1542-1547. 10.3341/jkos.2020.61.12.1542.

Relentless Placoid Chorioretinitis in a Young Man

• Kim TH
• Kim CZ
• Lee SU
• Lee SJ
• Noh GM

• KMID: 2511299
• DOI: http://doi.org/10.3341/jkos.2020.61.12.1542

Abstract

Purpose
To report a patient with relentless placoid chorioretinitis who showed recurrent multiple placoid lesions and retinal pigment epithelial atrophic changes in both eyes for more than 16 months.
Case summary
A 21-year-old man visited our clinic because of visual disturbance in both eyes. The best-corrected visual acuities were 20/50 and 20/20 in the right and left eyes, respectively. The fundus showed multiple whitish placoid lesions from the posterior pole to the mid-periphery. There were no anterior chamber inflammation signs. To exclude systemic and infectious etiologies, laboratory workup was performed. All tests were negative except for the serological types HLAB13 and B51. Based on clinical estimation, we made a diagnosis of acute posterior multifocal placoid pigment epitheliopathy or posterior uveitis and prescribed oral methylprednisolone for the patient. However, multiple white dot lesions occurred repeatedly in both eyes for 7 months. With the oral methylprednisolone and immunosuppressive treatment, the best-corrected visual acuity of both eyes was maintained at 20/20 without further recurrence 16 months after the first visit. The lesions left atrophic findings in the retinal pigment epithelium. We diagnosed the patient with relentless placoid chorioretinitis, based on the prolonged clinical course and widespread lesion distribution.
Conclusions
Relentless placoid chorioretinitis should be considered in patients with chronically progressive multiple white dot lesions and retinal pigment epithelium atrophic changes between the central pole and the periphery. Aggressive immunosuppressive treatment should be performed to improve the patient's visual outcome.

Keyword

Choroiditis; Placoid chorioretinitis; Relentless; Uveitis