Idiopathic choroidal neovascularization as an early manifestation of inflammatory chorioretinal diseases

We describe four patients with idiopathic choroidal neovascularization (ICNV) who developed inflammatory chorioretinal diseases in the ipsilateral or contralateral eye.

The medical records of 58 eyes of 58 patients with an initial diagnosis of ICNV (age range, 19-49 years; mean, 34.9 years) were reviewed.

Of the 58 patients, 4 women (7.0%) with moderate to high myopia (age range, 17-39 years) developed inflammatory chorioretinal diseases. In Cases 1 and 2, white dots were transiently seen in the deep retina of the contralateral eye, consistent with the clinical features of multiple evanescent white dot syndrome (MEWDS). In Case 3, vitritis and multifocal white spots emerged in the ipsilateral eye. These white spots spread throughout the ocular fundus and progressed to punched-out chorioretinal scars, which led to a diagnosis of multifocal choroiditis (MFC). In Case 4, an enlarged blind spot and a few chorioretinal scars around the optic nerve head developed without vitritis in the ipsilateral eye, suggesting a diagnosis of punctate inner choroidopathy (PIC).

These findings suggest that ICNV can be an early manifestation of inflammatory chorioretinal diseases, including MEWDS, MFC, and PIC.