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Table 2 Features of inflammatory choroidal neovascularization (CNV) commonly associated with infectious uveitis

From: An update on inflammatory choroidal neovascularization: epidemiology, multimodal imaging, and management

 

Presumed Ocular Histoplasmosis Syndrome (POHS) [135,136,137,138]

Toxoplasmosis [88, 124, 139, 140]

Intraocular tuberculosis [20, 93, 141, 142]

West Nile virus chorioretinitis [143,144,145]

Prevalence

Frequent; present in majority cases

Estimated between 0.3–19%

Uncommon; prevalence not known

Only few cases (< 5) reported

Location of CNV

CNV is seen at the edge of a pre-existing scar in the macular or peripapillary region

CNV typically grows close to the edge of an atrophic chorioretinal scar

CNV is typically adjacent to the healed choroidal granuloma or to a healed choroiditis scar

CNV is adjacent to chorioretinal scars

Morphology of CNV

Active lesions have a disciform appearance at the macula, with a green-gray subretinal lacy discoloration and surrounding pigment. Inactive CNV appears as a white disciform scar with fibrovascular tissue

Active CNV appears as an outer retinal lesion close to the scar with associated hemorrhages and intra- or subretinal fluid.

CNV may present as a subretinal lesion with hemorrhages and intra- or subretinal fluid. Rarely, type 1 CNV may be detected only using imaging

CNV presents as a chorioretinal lesion with subretinal fluid and area of retinal hemorrhage

Associated inflammatory lesions

The triad of POHS includes the presence of peripapillary atrophy or pigmentation, histo spots (focal round-shaped chorioretinal lesions), and absence of overlying vitritis

Recurrent disease appears as an oval or circular whitish focal area of retinochoroiditis in the periphery of old atrophic lesions; dense overlying vitritis (headlight-in-fog); perivasculitis with diffuse venous sheathing; segmental arteriolar plaques

Choroiditis may have amoeboid lesions with central healing and active margins (serpiginous choroiditis) or it may present with choroidal granulomas

There is multifocal chorioretinitis with vitritis; multiple active chorioretinal lesions have the appearance of deep, creamy lesions and are 200–1000 μm in size. Inactive lesions are partly atrophic and partly pigmented with a “target-like appearance.”