Treatment Approach for Multifocal Choroiditis, Panuveitis, and Subretinal Fibrosis Spectrum

Disease Spectrum and Clinical Recognition

The disease predominantly affects young to middle-aged adults, shows female predominance, and typically presents bilaterally, though rare unilateral cases exist, according to research published in Progress in Retinal and Eye Research 1
Multifocal choroiditis with panuveitis (MCP) is characterized by multiple yellow-white or gray focal lesions at the level of the retinal pigment epithelium and choroid, accompanied by inflammation in all uveal compartments, as described in Progress in Retinal and Eye Research 1

Multimodal imaging, including OCT, fluorescein angiography (FA), indocyanine green angiography (ICGA), and OCT-angiography, is essential to establish diagnosis and guide treatment, as outlined in Progress in Retinal and Eye Research 1
OCT identifies subretinal fluid, outer retinal disruption, cystoid macular edema, and subretinal fibrosis, according to Progress in Retinal and Eye Research 1
Fluorescein angiography (FA) demonstrates focal leakage points and choroidal neovascularization, as described in Progress in Retinal and Eye Research 1
Indocyanine green angiography (ICGA) shows hypofluorescent changes on late-phase imaging characteristic of white dot syndromes, according to Progress in Retinal and Eye Research 1
OCT-angiography detects neovascular networks when present, as outlined in Progress in Retinal and Eye Research 1

Systemic corticosteroids should only be used in combination with immunosuppressive agents, never as monotherapy, as recommended by Praxis Medical Insights: Practical Summaries of Clinical Guidelines 2
Local corticosteroids (topical drops, periocular injections) may be used for acute inflammation control, according to Progress in Retinal and Eye Research 1

Intravitreal anti-VEGF injections are the primary treatment for choroidal neovascularization, as described in Progress in Retinal and Eye Research 1
Photodynamic therapy may be considered as adjunctive treatment in select cases, according to Progress in Retinal and Eye Research 1

Regular ophthalmologic surveillance is mandatory, with monitoring for at least 3 years after achieving remission to detect recurrence early, as recommended by Praxis Medical Insights: Practical Summaries of Clinical Guidelines 2