Multimodal Imaging and Long-Term Treatment Outcomes of Relentless Placoid Chorioretinitis

Relentless placoid chorioretinitis (RPC) is a rare condition and although it may require long-term immunosuppressive therapy, there are no standardized treatment guidelines. Within this study, we discuss outcomes of the largest group of patients from a single institution with a diagnosis of RPC. This is a retrospective cohort study of patients diagnosed with RPC treated at the Associated Retinal Consultants in Royal Oak, Michigan from January 2015 to January 2024. A total of eight patients (11 eyes) were included. Initial treatments included oral prednisone (10 of 11 eyes) and topical steroids (5 of 11 eyes). Four patients were treated with methotrexate as their initial IMT agent and achieved disease quiescence. One patient (2 eyes) was treated with cyclosporine followed by mycophenolate and successfully tapered off all therapy after remaining quiescent for more than ten years. All patients were able to achieve control of disease activity with no active lesions on final follow-up. Visual acuity either improved or remained stable in all eleven eyes with presenting and final mean logMAR visual acuities of 0.61 (20/80, Snellen) and 0.10 (20/25, Snellen), respectively (p=0.013) [A mean of 3.4 lines of improvement]. The four patients treated with methotrexate had presenting and final mean logMAR visual acuities of 1.13 (20/320, Snellen) and 0.27 (20/40, Snellen), respectively (p=0.047) [A mean of 6 lines of improvement]. To our knowledge, this is the largest cohort of RPC patients in a single study. Care for these patients involves multimodal imaging as well as multidisciplinary care.