A Case of Ampiginous Choroiditis

Systemic combined with intravitreal methotrexate for relentless placoid chorioretinitis: A case report

BACKGROUND

We describe a case of relentless placoid chorioretinitis (RPC) that progressed despite administration of peribulbar and systemic corticosteroids, and was resolved by systemic combined with intravitreal methotrexate.

CASE SUMMARY

A 16-year-old male reported painless blurred vision and a temporal scotoma in his right eye for one week. Due to widespread distribution and continuous enlargement, multimodal imaging of the lesions led to the diagnosis of RPC. Lesions in the right eye extended despite peribulbar injection of triamcinolone acetonide, but the progression was immediately terminated by a single dose of intravitreal methotrexate. A new fresh lesion occurred in the contralateral eye despite systemic prednisolone but was resolved by oral methotrexate.

CONCLUSION

Systemic immunosuppressants should be given upon RPC diagnosis. Intravitreal methotrexate immediately halted progression and may be considered for sight-threatening cases as part of the initial therapy.

Bilateral Ampiginous Choroiditis following Confirmed SARS-CoV-2 Infection

INTRODUCTION

Ampiginous Choroiditis is a rare posterior uveitis that combines clinical features of Acute Multifocal Posterior Placoid Pigment Epitheliopathy and Serpiginous Chorioretinitis. Its pathophysiology is poorly understood and further studies are necessary to understand which mechanisms start the immunologic reaction.

CASE REPORT

The purpose of this article is to report a well-documented case of Ampiginous Choroiditis following in seven days a RT-PCR confirmed SARS-CoV-2 infection, suggesting that the infection might have contributed as a trigger.

CONCLUSION

Timely diagnosis and correct treatment are paramount to improve the visual outcomes, and the patient had successful response to systemic steroids.