Multifocal choroiditis and panuveitis: immunomodulatory therapy.

PURPOSE: To report our analysis of the efficacy of immunomodulatory therapy on the course of 19 patients with multifocal choroiditis and panuveitis (MCP).

DESIGN: Retrospective, noncomparative, interventional case series.

PARTICIPANTS: Nineteen patients with multifocal choroiditis with panuveitis evaluated on the Ocular Immunology and Uveitis Service of the Massachusetts Eye and Ear Infirmary from 1978 to 2000.

METHODS: Fifteen patients were treated with systemic immunomodulatory therapy; 4 patients (who refused therapy) were treated with systemic steroids. All patients were analyzed for control of inflammation, visual acuity outcome, and tolerance of immunomodulatory therapy.

MAIN OUTCOME MEASURES: Control of inflammation and visual acuity.

RESULTS: Nineteen patients with bilateral MCP with a mean follow-up of 72.7 months were studied. Fifteen were treated with immunomodulatory agents, whereas 4 patients received only systemic steroids; these 4 developed serious systemic steroid-related complications, and 12 others had cataract and/or glaucoma related to chronic topical, regional, or systemic steroid use before immunomodulatory therapy. Two patients who refused immunomodulatory therapy lost considerable vision in three of their four eyes. Of the 15 patients treated with immunomodulatory drugs, 7 patients lost considerable vision in one eye on steroid therapy but maintained good vision in the other eye once immunomodulatory therapy was instituted. No patient lost vision in any eye once he or she was treated with immunomodulatory treatment.

CONCLUSIONS: Immunomodulatory therapy controls inflammation and preserves vision in patients with multifocal choroiditis and panuveitis.