Some physicians have tried acyclovir, but the value of this is unclear. When there's macular involvement with decreased visual acuity, steroids appear to hasten resolution of the acute lesion and prevent recurrences. Despite recurrences, most patients maintain good central and peripheral vision in at least one eye. This disease, which predominantly affects young women, has no known etiology. One study implicated the Epstein-Barr virus, but other investigations failed to confirm this.
Patients often complain first of impaired central acuity in one eye.
Eventually, the fellow eye usually becomes involved. Acute white lesions and old, healed atrophic lesions may be present simultaneously. Peripapillary atrophy or scarring and linear atrophic and hypertrophic streaks at the equator may also be present. Hyperplasia of the RPE may cause an enlargement of the chorioretinal scars and subretinal fibrosis. Inactive lesions have a punched-out appearance.