The following transcript has been edited for clarity.

My name is Arthi Venkat, MD, MS. I’m a medical retina and uveitis specialist at the University of Virginia, and I had the pleasure of presenting on unusual forms of placoid chorioretinopathy at the Retina World Congress meeting this year. My presentation describes a gentleman who presented with vision loss in 1 eye. It was a pretty dramatic amount of vision loss—he went from 20/40 to count fingers—and was found to have this very aggressive form of placoid chorioretinopathy in both eyes, even though the 1 eye was more involved. And he was sent to me urgently for concern for an infectious process.

One of the elements of my presentation covers how to differentiate a process like this, which ended up being noninfectious, from some infectious processes that we may see, such as viral retinitis, for example. This patient had outer retinal changes that were indicative of a noninfectious chorioretinitis. There were also signs that he had had some chronicity—there was evidence that some of this had been going on for longer than the stated timeframe. That also gives us a little reassurance that perhaps this is not an infectious process, where we wouldn’t expect that sort of chronicity, because those infectious processes happened quickly enough that we would see that everything looks pretty active at the time of presentation in most cases.

After a good investigation into possible other etiologies, we were able to determine that this was a condition in the spectrum of placoid chorioretinopathy. There are many different types. The most common one that we all maybe hear about is something called APMPPE, or acute posterior multifocal placoid pigment epitheliopathy, which is usually a self-limited type of placoid chorioretinitis. But then there are more aggressive types, which is what we felt this patient had. We thought that most likely his manifestation was something called ampiginous chorioretinitis, which is a hybrid of APMPPE and another type of plaquoid chorioretinitis called serpiginous choroiditis. The hybrid of that is ampiginous chorioretinitis.

He did quite well. We treated him with systemic steroids initially as well as intravitreal dexamethasone implants. And then ultimately he had to be started on immunomodulatory therapy and is quiescent on infliximab infusions every 8 weeks. RP