Introduction:

Relentless placoid chorioretinitis (RPC), also known as ampiginous choroiditis, is a rare condition that belongs to the same spectrum of diseases as acute posterior multifocal placoid pigment epitheliopathy and serpiginous choroiditis, with a more aggressive and treatment-resistant course. Cause remains unknown. Defined as yellowish-white, small, recurrent, placoid lesions with geographic borders in mid-periphery and far periphery of fundus with variable posterior pole involvement, with continuous development of new lesions without appropriate immunomodulatory therapy. Various immunomodulatory therapies were used for disease control; lack of consensus on treatment strategies and efficacy of these treatments is not known

Objectives:

• To report a case series of management of patients with RPC using immunomodulatory therapies
• Literature review of treatment strategies

Methods:

• Descriptive retrospective observational case series • All patients were screened for other possible infectious and non-infectious causes of uveitis

Discussion & Conclusion:
• RPC should be diagnosed early so that effective treatment
can be initiated, as RPC can still have a good visual
prognosis when immunosuppression is commenced early.
• Most RPC cases are refractory to oral steroid monotherapy
and require steroid-sparing immunosuppression to control
disease.
• We demonstrated effective control of disease using
Mycophenolate Mofetil and Azathioprine, as also previously
reported in few case reports/series.
• Effectiveness of the biologic drugs such as Adalimumab is
usually effective and well-tolerated. One of our patients
demonstrated long-term disease control of up to 47 months
with Adalimumab.
• Further studies with larger patient cohorts and standardised
treatment regime are necessary to determine the efficacy of
specific steroid-sparing immunosuppression.