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Idiopathic Multifocal Choroiditis and Punctate Inner Choroidopathy - Evaluation of Risk Factors for Increased Relapse
Evianne L de Groot1, Joke H de Boer1, Jeannette Ossewaarde-van Norel1
1Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands.
Introduction:
The aim of this study was to describe the course of disease in patients with idiopathic multifocal choroiditis (MFC) and punctate inner choroidopathy (PIC) and to identify risk factors associated with an increased relapse rate of disease activity.
Methods:
In this prospective observational cohort study, demographical and clinical data were collected concerning the relapses rate of disease activity, the conclusions of the multimodal imaging results, treatment, complications, and self-reported quality of life. Disease activity was defined as new inflammatory lesions or active inflammation in preexisting chorioretinal lesions either with or without active choroidal neovascularization (CNV). Linear regression analysis was performed to identify risk factors associated with an increased relapse rate.
Results:
In total, 122 eyes of 82 patients (93% females) were included with a median age (IQR) of 45 (37-54) years. A history of secondary CNV was present in 66% of the eyes. During follow-up, the best-corrected visual acuity remained stable despite a median relapse rate (IQR) of 1.0 (0.25-3). Cycles of oral corticosteroids were given in 59% of the patients, 72% were treated at baseline or started treatment during follow-up with a disease-modifying antirheumatic drug (DMARD), and 35% with a biological agent in addition to the DMARD. Both a history of secondary CNV (B = 1.2, 95% CI: 0.7-1.7, p = 3.6 × 10-5) and high myopia (<-6 diopters) (B = 0.6, 95% CI: 0.1-1.1, p = 0.02) independently increased the relapse rate of disease activity.
Discussion/Conclusion:
A history of secondary CNV and high myopia were associated with an increased relapse rate of disease activity. Moreover, the results of this study emphasize the challenging character of treating patients with MFC/PIC.
Insights
Idiopathic multifocal choroiditis (MFC) and punctate inner choroidopathy (PIC) patients with secondary choroidal neovascularization (CNV) or high myopia experienced more disease relapses. These factors complicate treatment for MFC and PIC.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Inflammatory Eye Conditions
Background:
- Idiopathic multifocal choroiditis (MFC) and punctate inner choroidopathy (PIC) are inflammatory eye conditions.
- Understanding disease course and relapse predictors is crucial for patient management.
Purpose of the Study:
- To describe the disease course in patients with MFC and PIC.
- To identify risk factors for increased disease activity relapses.
Main Methods:
- Prospective observational cohort study.
- Collected demographical, clinical, imaging, treatment, and quality of life data.
- Linear regression analysis identified risk factors for relapse rate.
Main Results:
- 122 eyes from 82 patients (93% female, median age 45) were analyzed.
- Secondary choroidal neovascularization (CNV) (66%) and high myopia (<-6D) independently predicted increased relapse rates.
- Visual acuity remained stable despite a median relapse rate of 1.0.
Conclusions:
- Secondary CNV and high myopia are associated with higher relapse rates in MFC/PIC.
- Treating these conditions presents significant challenges.
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