Chorioretinitis

What is chorioretinitis?

Chorioretinitis is a type of uveitis, an eye inflammation. In chorioretinitis, the inflammation affects the posterior (back parts) of your eye — your choroid and retina.

Your choroid is a layer of eye tissue that has blood vessels located between your retina and sclera. Your sclera is the strong tissue that you might call “the white of your eye.” You can lose vision if you have issues with the choroid because it provides your retina with nutrients.

Many things can cause your retina to swell, including infections. Some of these infections are present at birth (congenital). Others happen over time (acquired).

When the inflammation is bad enough to harm your eye, the chorioretinitis becomes chorioretinopathy. The “-pathy” refers to the damage. Contact an eye care professional if you have symptoms like blurred vision, eye pain or sensitivity to light.

What are the symptoms of chorioretinitis?

Chorioretinitis symptoms may include:

• Seeing black spots, floaters or flashes of light.
• Red eyes.
• Blurred vision.
• Eye pain.
• Sensitivity to light (photophobia).
• Excessive eye watering or tearing.
• Difficulty seeing colors.

What causes chorioretinitis?

There are infectious causes of chorioretinitis and non-infectious causes.

Infectious causes of chorioretinitis

These infections can be present when you’re born or happen over time. Infectious diseases that can cause chorioretinitis include:

• Toxoplasmosis. This is the most common cause of chorioretinitis.
• Tuberculosis.
• Cytomegalovirus.
• Syphilis.

Other infections are caused by viruses like Zika, rubella and varicella-zoster, as well as fungal infections.

Non-infectious causes of chorioretinitis

Non-infectious conditions that can cause chorioretinitis include:

• Eye injuries.
• Autoimmune and inflammatory illnesses, including rheumatoid arthritis, sarcoidosis and Behçet’s disease.
• Some types of cancer, like lymphoma or metastatic disease
• Some genetic conditions.

What are the complications of chorioretinitis?

Untreated, chorioretinitis can cause loss of vision that can become permanent.

How is chorioretinitis diagnosed?

An eye care provider will be able to see your retina if they do a dilated eye exam. They’ll give you eye drops to make your eyes wider (dilate) so they can see all the way to the back of your eye. Sometimes, providers can see chorioretinal scars, or pieces of tissue or patches of color at the back of your eye.

What tests will be done to diagnose chorioretinitis?

In addition to the eye exam, your provider may do the following tests:

• Lab tests on material swabbed from your eye. These tests can help identify infections.
• Optical coherence tomography. This is an imaging test using reflected light to take pictures of the back of your eye.
• Fluorescein angiography. This test lets your provider see the blood vessels at the back of your eye.
• Indocyanine green (ICG) angiography. This imaging test lets your provider see the blood vessels of the choroid, the layer under your retina.

If you have another condition that is causing chorioretinitis, your provider might order additional tests.

How is chorioretinitis treated?

Ophthalmologists (eye doctors) treat most cases of chorioretinitis with steroids to reduce inflammation. But you won’t be able to take steroids for an extended length of time. So, your eye care provider may work with a rheumatologist to prescribe steroid-sparing medications that suppress your immune system. In chorioretinitis caused by an infection, your provider will prescribe something to treat the infection, depending on the cause of the infection. These medicines include:

• Antibiotics.
• Antifungals.
• Antiparasitics.
• Antivirals.

In very rare cases, a provider might suggest a vitrectomy. This surgery removes fluid and debris from your eye.

You should always take your medications for as long as your prescription is written and in the way that your provider recommends.

Can chorioretinitis be prevented?

You may be able to reduce your risk of chorioretinitis by:

• Taking care to prevent infections. These actions can include washing your hands thoroughly, avoiding people who are sick and practicing safe sex.
• Making and keeping appointments with eye care providers according to the schedule they suggest.
• Contacting an eye care provider if you have any changes in your vision in between appointments.
• Taking care of your general health by eating well, getting exercise and managing chronic conditions.

What can I expect if I have chorioretinitis?

If you have chorioretinitis and you receive treatment for it and/or the underlying condition causing it, your outlook is good. When you have this condition, you’ll need frequent visits with your ophthalmologist.

Many people don’t have lasting issues with their vision.

But chorioretinitis can affect your vision if it’s not treated. One complication is choriogenin atrophy, which means that the affected parts of your eye — your retina and choroid — may become smaller and not work as well as they should.

Untreated chorioretinitis can lead to vision loss, even blindness.

When should I see my healthcare provider?

If you have a chorioretinitis diagnosis, your provider will tell you what issues may come up with your eyes. If you have a treatment plan and you feel like it’s not working, you should discuss this with your provider.

At any time, with or without an eye disease diagnosis, you should contact an eye care provider or go to an emergency room if you have any type of eye injury or a sudden loss of vision.

What questions should I ask my doctor?

You may want to ask your healthcare provider questions about chorioretinitis, including:

• What’s the cause of my illness?
• What treatment do you recommend?
• Are there side effects to this treatment?
• What complications should I look out for?
• Is this illness likely to affect anyone else in my family?

A note from Cleveland Clinic

Most people have times when their eyes water or feel sore. But if you have blurred vision, eye pain, trouble seeing colors or a lot of floaters, contact a healthcare provider right away — it could be chorioretinitis, inflammation of the choroid and retina of your eye. The sooner you receive treatment, the better the outcome.