Introduction
Multifocal Choroiditis affects >40y/o with multiple small circular well-defined yellow-white inflammatory lesions in the choroid and RPE
- Associated with vitritis
- Blurry Vision
Punctate Inner Choroidopathy affects <40y/o with smaller lesions close to the posterior pole. Less likely to have vitritis
- Blurry vision
Pathophysiology is unknown, but thought to have genetic predisposition to autoimmune or inflammatory disease leads to a response against antigens in the outer retina and inner choroid.
Dead Giveaways
PIC:
Fundus:
Multiple small circular inflammatory lesions in the RPE and choroid
Later progresses to atrophic chorioretinal scars overtime
Yellow-white lesions may develop pigmented border
Lesions are limited to posterior pole, and not involved with vitritis
Shows the PIC with pigments and neovascularisation 
FAF shows lesions which are primarily hypo-AF (dark), with hyper-reflective borders in the acute stage. Overtime, they become completely dark without hyper-AF, due to chorioretinal atrophy.
OCT:
89% of lesions in PIC involve the RPE
RPE involved elevations, and disruptions with a seemingly intact Bruch's membrane
Line scans through hyper-AF shows subretinal deposits, which are typically dome shaped
Kalogeropoulos D. et al. 2024.
MFC:
Fundus:
Well defined whitish yellow inflammatory lesions similar to PIC, but are more widespread
From Moran Core. Shows a severe MFC with panuveitis. 
Shows the hypo-AF lesions present in MFC. Some hyper-AF lesions can be seen (very little)
OCT:
Outer retinal atrophy seen and hypertransmission to the choroid
Above the atrophy is a hyper-reflective RPE deposit
Hypo-AF regions corresponds to an area of chorioretinal atrophy
Shows the sub-retinal deposits at numerous points, and a large area of chorioretinal atrophy under the macula.
diagnostic features
Symptoms:
Reduction in VA, photopsia, scotoma
Complications:
CNV (69%) and subretinal fibrosis (56%)
Possible ERM and macular oedema
Presumed ocular histoplasmosis syndrome (POHS) is also apart of this spectrum, but these conditions are not triggered by histoplasmosis
Prognosis is typically guarded