Macular geographic helicoid choroidopathy

We treated eight patients who had lesions typical of geographic helicoid peripapillary choroidopathy (GHPC) (also called serpiginous choroidopathy or geographic choroiditis) initially affecting the macula. The lesions were similar in funduscopic and fluorescein angiographic appearance to lesions of GHPC, but they were located initially or exclusively in the macular region. The recurrent nature of these lesions (eventually involving the peripapillary retina in two eyes) and their association with GHPC lesions of the fellow eye in four patients suggest that this macular disease is a different manifestation of the same condition that usually starts adjacent to the optic nerve head. The causative agent was not identified. Prompt treatment of initial or recurrent acute disease with corticosteroid medication was associated with remission and preserved vision in all eight eyes so treated.