PubMed · 2228476
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B C Joondeph, H H Tessler. 1990. Multifocal choroiditis.. https://doi.org/10.1097/00004397-199030040-00015
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Geographic (serpiginous) choroiditis, also known as Geographic Helicoid Peripapillary Choroidopathy, is a rare, chronic, and progressive, bilateral disorder primarily involving the choriocapillaris, retinal pigment epithelium, and the overlying sensory retina. Progression typically occurs as pseudopodial extensions away from the optic discs and usually infringes upon the macula and foveal region. The disease occurs fairly acutely, in young to middle age patients with no sexual predilection. These patients commonly present with sudden, painless vision loss in one eye, which later, most likely will affect the other eye. The disease is always bilateral, but usually asymmetrical in appearance. It presents with active and inactive stages. The etiology is essentially unknown. This paper will present a case of geographic choroidopathy with differential diagnosis considerations and appropriate optometric management.
The clinical differentiation between multifocal choroiditis and panuveitis (MCP) and the presumed ocular histoplasmosis syndrome (POHS) can be difficult. Each condition is associated with peripapillary atrophy, chorioretinal spots, and subretinal neovascularization. Peripheral chorioretinal streaks have been described as the "fourth sign" of POHS. A consecutive series of patients with MCP were examined to determine the prevalence of peripheral chorioretinal streaks. Examination of 47 involved eyes in 25 patients revealed three eyes with streaks near the equator. These findings suggest that the presence of peripheral linear streaks cannot be used to differentiate the POHS from MCP.