Ampiginous choroiditis: heterogeneity in 2 cases

PurposeWe report two heterogeneous cases with ampiginous choroiditis and describe fundus photography, blue light autofluorescence, fluorescein angiography, indocyanine green angiography and cross‐sectional optical coherence tomography.MethodsObservational report about 2 heterogeneous cases of ampiginous choroiditis.ResultsA 70‐year old woman and a 21‐year old man were referred to us with posterior uveitis. The female patient showed unilateral scattered chorioretinal lesions, whereas the male patient featured bilateral geographic chorioretinal lesions. In the first case, the lesions did not threaten the fovea. In the second case, the lesions involved the fovea of one eye and threatened the fovea of the second eye. Both patients presented with lesions showing blue light hyperautofluorescence. Fluorescein angiography showed early hypofluorescence with late staining of the borders whereas indocyanine green angiography showed hypofluorescent lesions through the early and late stages. Cross‐sectional optical coherence tomography of the lesions showed outer retinal atrophy. The tuberculin skin test and interferon‐gamma release assay were negative. The diagnosis of ampiginous choroiditis was withholded. A stepladder approach to obtain a corticosteroid‐sparing immunomodulatory treatment was initiated with azathioprine and visual acuity remained stable.ConclusionsAmpiginous choroiditis is a primary inflammatory choriocapillaropathy with distinct features. However, the heterogeneous clinical findings can complicate the diagnosis.