Choroiditis means inflammation in the choroid, which is a thin, rich blood-vessel layer under the retina at the back of the eye. This layer feeds the retina and helps it stay healthy. When the choroid is inflamed, the retina can also get inflamed and damaged, so vision can become blurred or even lost if the disease is not treated. Doctors see choroiditis as one of the causes of posterior uveitis, which is inflammation in the back part of the eye.
Choroiditis is long-lasting inflammation in the choroid, the thin, rich blood layer at the back of the eye that feeds the retina. When this layer is inflamed, it can damage the retina, blur vision, and sometimes cause permanent vision loss if treatment is delayed.[1] Choroiditis can be caused by infections (like viruses, bacteria, parasites), autoimmune diseases (when your own immune system attacks the eye), or it can be “idiopathic,” meaning doctors do not find a clear cause.[2]
In many people, inflammation affects both the choroid and the retina at the same time. In that case, doctors often use the word chorioretinitis (choroid + retina + “itis,” which means inflammation). The problem can be caused by infection, by the immune system attacking the eye, or by other body diseases that also involve the eye.
The inflammation can be mild and quiet, or it can be strong and painful. It can affect one eye or both eyes. Some forms come and go in attacks, while others are long-lasting (chronic). Because the choroid is close to the retina, untreated choroiditis can leave scars that permanently affect central or side vision.
Other names for choroiditis
Doctors and articles may use several names that refer to the same or related conditions. Knowing these names helps you recognise that they all involve inflammation of the choroid.
Chorioretinitis – used when both the choroid and retina are inflamed together.
Retinochoroiditis – another way to say chorioretinitis; order of words is reversed but meaning is the same.
Posterior uveitis – main group name for inflammation at the back of the eye, including choroiditis and chorioretinitis.
Birdshot chorioretinopathy / birdshot uveitis – a special autoimmune type of choroiditis with many small pale spots in the back of the eye.
Serpiginous choroiditis – a rare type where inflamed patches spread in a snake-like or geographic pattern from around the optic nerve.
Multifocal choroiditis and panuveitis (MCP/MFCPU) – a type with many small spots of inflammation in the choroid and wide inflammation in the eye.
These names can look confusing, but they all describe where the inflammation is and what pattern doctors see when they look into the eye.
Types of choroiditis
Doctors often group choroiditis by cause and by pattern they see on eye scans and examination.
Infectious choroiditis / chorioretinitis – caused by germs (parasites, bacteria, viruses, fungi) that reach the eye.
Non-infectious / autoimmune choroiditis – caused by the immune system attacking the eye without a germ. Often linked with body autoimmune diseases.
Birdshot chorioretinopathy (HLA-A29 uveitis) – chronic autoimmune choroiditis strongly linked to a tissue type called HLA-A29.
Serpiginous choroiditis – chronic, recurrent, snake-like patches of inflammation that can severely affect the macula (central retina).
Multifocal choroiditis with panuveitis – many small lesions in the choroid plus inflammation in the vitreous gel and sometimes the front of the eye.
Punctate inner choroiditis (PIC) – many small, inner choroidal spots, often in young near-sighted women, sometimes grouped with multifocal choroiditis.
Tuberculous choroiditis – inflammation due to tuberculosis infection that has spread to the eye.
Syphilitic chorioretinitis – inflammation due to syphilis bacteria infecting the back of the eye.
Toxoplasma chorioretinitis – common infectious cause from the parasite Toxoplasma gondii, often in people with weak immune systems.
Fungal chorioretinitis – from fungi such as Candida or Histoplasma, usually in very ill or immunocompromised patients.
Many patients never get a clear single label. In those cases, doctors may say “idiopathic choroiditis” (no known cause) but still treat the inflammation to protect vision.
Causes of choroiditis
Choroiditis has many possible causes. Often, more than one factor is present at the same time, such as infection plus weak immunity.
1. Toxoplasma infection
The parasite Toxoplasma gondii can travel in the bloodstream and settle in the choroid and retina. It may come from undercooked meat or contact with infected cat stool. After the first infection, the parasite can stay “sleeping” in the eye and later become active again, causing new choroiditis attacks and scars.
2. Tuberculosis (TB)
The TB bacteria can spread from the lungs or other organs to the eye. In the choroid, TB can cause yellow-white spots or larger lesions. Eye TB may appear even when lung tests are not very clear, so doctors often test for TB when choroiditis is unexplained.
3. Syphilis
Syphilis is a sexually transmitted infection that can reach the eye in late stages. It can inflame the choroid and retina and often mimics other eye diseases. Because syphilis is treatable with antibiotics, testing for it is important in any unexplained posterior uveitis.
4. Viral infections (herpes group, CMV, others)
Viruses like herpes simplex, varicella-zoster (shingles), and cytomegalovirus (CMV) can inflame the back of the eye, especially in people with weak immune systems. These viruses can damage blood vessels and retinal tissue, leading to areas of chorioretinitis.
5. Fungal infections
Fungi such as Candida may spread to the eye through the blood in very ill patients, in people with long-term IV lines, or those on strong antibiotics or steroids. Fungal chorioretinitis often presents with white or creamy lesions and can be life-threatening if it reflects widespread infection in the body.
6. Bacterial infections other than TB and syphilis
Other bacteria (for example, Bartonella, Borrelia in Lyme disease, or bacteria from sepsis) can cause choroiditis. In these cases, finding and treating the underlying infection is crucial to protect both eye and general health.
7. Birdshot chorioretinopathy (autoimmune)
Birdshot chorioretinopathy is a chronic autoimmune disease that targets the choroid and retina. Almost all patients have a special tissue type called HLA-A29. The immune system mistakenly attacks the eye, causing diffuse small pale spots and gradual vision problems.
8. Serpiginous choroiditis (autoimmune / idiopathic)
Serpiginous choroiditis is a chronic, recurrent inflammatory disease of the choroid, retinal pigment epithelium, and choriocapillaris. The exact cause is unclear but is thought to be immune-mediated. It often affects middle-aged adults and can cause large areas of damage spreading from the optic nerve area.
9. Multifocal choroiditis with panuveitis (MCP)
MCP is an idiopathic (unknown cause) inflammatory disorder with many small spots in the choroid and inflammation throughout the eye. It commonly affects young, near-sighted women. Autoimmune mechanisms are suspected because it often responds to immune-suppressing drugs.
10. Sarcoidosis
Sarcoidosis is an inflammatory disease that forms small clumps of immune cells called granulomas in many organs, including the lungs and eyes. When sarcoid involves the choroid, it can cause granulomatous choroiditis and other forms of uveitis.
11. Behçet disease
Behçet disease is a systemic vasculitis that can inflame blood vessels in the eye as well as in the skin, mouth, and genitals. It often causes repeated attacks of posterior uveitis and can involve the choroid and retina, leading to scarring if not controlled.
12. Systemic lupus erythematosus and other connective tissue diseases
Autoimmune diseases like lupus, rheumatoid arthritis, or mixed connective tissue disease can lead to immune attack on eye structures. In some patients, the choroid and retina become inflamed as part of a general flare of the disease.
13. Inflammatory bowel disease (Crohn’s disease, ulcerative colitis)
Choroiditis and other forms of uveitis are recognized extra-intestinal complications of inflammatory bowel disease. Inflammation in the gut is accompanied by immune disturbances that also affect the eye.
14. Multiple sclerosis and demyelinating diseases
Some demyelinating diseases (where the immune system attacks nerve coating) can associate with posterior uveitis. The exact mechanism is complex but may involve shared immune pathways that also affect the retina and choroid.
15. Eye trauma
Severe blunt or penetrating trauma can trigger inflammation inside the eye, including the choroid. Sometimes, the immune system reacts to eye proteins exposed by injury, leading to long-lasting uveitis after the trauma.
16. Eye surgery (post-operative inflammation)
Inflammation after cataract surgery or other eye operations is usually short-lived, but in some people, it becomes stronger and more persistent, involving the choroid and retina. Rarely, “sympathetic ophthalmia” occurs, where the uninjured eye also becomes inflamed.
17. Drug-induced uveitis
Certain medicines, including some immune checkpoint inhibitors, antibiotics, and anti-TNF agents, have been linked to posterior uveitis. In some patients this can include choroiditis-like changes, which tend to improve when the drug is stopped and inflammation is treated.
18. Intraocular lymphoma and other malignancy (masquerade syndrome)
Cancers like primary intraocular lymphoma can mimic choroiditis because they cause white or yellow lesions in the choroid and retina, with cells in the vitreous. These are not true inflammatory causes but “masquerade” as uveitis, so biopsy may be needed to confirm the diagnosis.
19. Immunodeficiency, including HIV infection
When the immune system is weak, opportunistic infections such as CMV, toxoplasma, or fungi can easily reach the eye and cause chorioretinitis. In these patients, choroiditis may be a sign of serious systemic infection.
20. Idiopathic (no identified cause)
In a significant number of patients, even after complete testing, no infection, autoimmune disease, or other systemic problem is found. Doctors then call the condition “idiopathic choroiditis.” Treatment still aims to calm the inflammation and protect vision, even if the trigger is unknown.
Symptoms of choroiditis
Symptoms depend on which part of the retina and choroid are inflamed and how severe the attack is. Some types start slowly, while others are sudden.
1. Blurred vision
The most common symptom is blurred or hazy vision, often in the central part of the visual field. Inflammation and fluid change the way light focuses on the retina, so images no longer look sharp.
2. Floaters
Floaters are small moving spots, lines, or cobweb shapes in the field of view. In choroiditis, inflammatory cells and debris in the vitreous gel throw shadows on the retina, making floaters more noticeable.
3. Sensitivity to light (photophobia)
Bright light may feel painful or uncomfortable. This happens because inflamed tissues are more sensitive, and light shining onto the retina increases irritation.
4. Flashes of light (photopsias)
Some patients notice brief flashes or flickers of light, especially in the dark. These are called photopsias and are caused by irritation or pulling on the retina from inflammation.
5. Dark spots or missing areas (scotomas)
Inflamed or scarred areas of the retina may cause blind spots where vision is missing or dim. People may notice a dark patch in the centre or side of their vision.
6. Distorted vision (metamorphopsia)
Straight lines may look wavy or bent. Faces and letters may look warped. This happens when inflammation or swelling distorts the central retina (macula), changing how it receives images.
7. Trouble seeing at night (nyctalopia)
Some forms, like birdshot chorioretinopathy, can affect rod cells that work in low light. Patients may find it very hard to see in dim rooms or at night.
8. Loss of colour vision (dyschromatopsia)
Colours may look washed out or “off.” This is due to damage or dysfunction in cone cells and retinal pathways that process colour information.
9. Decreased contrast and glare problems
Patients may see poorly in bright sunlight or when driving at night because of glare. Contrast between objects and background may seem reduced, making detailed tasks harder.
10. Peripheral vision loss
If scars or active lesions are in the outer retina, side vision can slowly shrink. People may bump into objects or have difficulty noticing things coming from the side.
11. Eye discomfort or mild pain
Some people feel a dull ache, pressure, or soreness in or around the eye. While many posterior uveitis cases are painless, discomfort can still occur, especially when the inflammation is stronger or other eye parts are involved.
12. Redness of the eye
Redness is less dramatic than in front-of-the-eye uveitis, but mild redness can appear if inflammation spreads or if there is also anterior uveitis.
13. Headache or eye strain
Because the inflamed eye is working harder to see clearly, some patients complain of headaches or a feeling of strain, especially with reading or computer work.
14. Sudden drop in vision
If a large area of the macula becomes inflamed or if complications like choroidal neovascular membranes or retinal detachment develop, vision can drop suddenly. This is an emergency and needs quick care.
15. Gradual, progressive visual decline
Chronic types like birdshot or serpiginous choroiditis can slowly damage more retina over time. Patients may not notice early changes but later find that their reading or driving vision has become quite poor.
Diagnostic tests for choroiditis
Diagnosing choroiditis needs both a careful eye exam and tests that search for infection, immune disease, or other causes. Doctors also use advanced imaging to see the choroid and retina layers.
Physical exam tests
1. Comprehensive eye and general physical examination
The ophthalmologist looks at the whole person, not just the eye. They check vital signs, skin, joints, mouth, lungs, and nervous system to look for signs of infection or autoimmune disease that might explain the choroiditis.
2. Visual acuity testing (Snellen chart)
Reading letters on a chart at a set distance measures how clearly each eye can see. Changes in visual acuity over time help the doctor judge how active the disease is and how well treatment is working.
3. Slit-lamp biomicroscopy with dilated fundus examination
A slit-lamp is a special microscope that lets the doctor see the front of the eye and, after dilating the pupil with drops, the lens, vitreous, retina, and choroid. They can see white or yellow lesions, scars, bleeding, or fluid that point to choroiditis.
4. Intraocular pressure measurement (tonometry)
Measuring eye pressure is important because inflammation or steroid treatment can raise pressure and lead to glaucoma. Tonometry uses a small device that briefly touches or blows a gentle puff against the eye surface.
Manual / bedside visual function tests
5. Confrontation visual field testing
The doctor sits in front of the patient and moves fingers in different directions to roughly map side vision. Abnormal results may suggest lesions in certain parts of the retina or nerve pathways.
6. Amsler grid test
The Amsler grid is a simple square with straight lines and a dot in the centre. The patient looks at the dot and says if lines look wavy, broken, or missing. Distorted or missing areas suggest macular involvement from choroiditis.
7. Colour vision testing (Ishihara plates or similar)
Patients look at coloured dot patterns and identify numbers or shapes. Difficulty seeing some patterns may show damage to cone cells or pathways that process colour, as seen in birdshot and other posterior uveitis.
8. Contrast sensitivity testing
This test measures how well a person can see faint objects against backgrounds of similar brightness. Choroiditis can reduce contrast even when the basic letter chart seems fairly normal, so this test helps detect subtle visual loss.
Laboratory and pathological tests
9. Complete blood count (CBC)
CBC can show anaemia, high or low white cell counts, or platelet problems. These findings may point toward infection, systemic inflammation, or blood diseases that can be linked with eye inflammation or masquerade as uveitis.
10. Inflammation markers (ESR and C-reactive protein)
High ESR or CRP levels show active inflammation somewhere in the body. While not specific, they support the idea of a systemic process in patients with choroiditis and guide further testing.
11. Infectious disease serology (toxoplasma, syphilis, HIV, others)
Blood tests for antibodies or other markers help detect infections like toxoplasmosis, syphilis, HIV, or other pathogens that can cause chorioretinitis. Correctly identifying an infection allows targeted antimicrobial treatment.
12. Tuberculosis testing (TST or IGRA)
Skin tests or blood tests for TB (like interferon-gamma release assays) are useful when TB choroiditis is suspected. Positive results, combined with chest imaging and eye findings, help support the diagnosis.
13. Autoimmune screening (ANA, rheumatoid factor, HLA typing including HLA-A29)
Tests such as antinuclear antibodies (ANA), rheumatoid factor, and specific HLA typing can show if a systemic autoimmune disease is present. For example, HLA-A29 positivity strongly supports birdshot chorioretinopathy.
14. ACE level and serum lysozyme (for sarcoidosis)
Elevated angiotensin-converting enzyme (ACE) or lysozyme levels can suggest sarcoidosis in patients with compatible chest imaging and eye signs. This can explain granulomatous choroiditis in some cases.
Electrodiagnostic tests
15. Electroretinography (ERG)
ERG measures the electrical responses of the retina to flashes of light. In chronic choroiditis or birdshot, ERG may show reduced function of rod and cone cells, even before severe structural damage is visible.
16. Visual evoked potentials (VEP)
VEP looks at electrical signals from the visual cortex in the brain when the patient sees a pattern or flash. Abnormal VEPs can help show if visual pathways are affected and distinguish eye disease from brain or optic nerve problems.
Imaging tests
17. Optical coherence tomography (OCT)
OCT is a non-contact scan that gives cross-section images of the retina and, in some settings, the choroid. It can show swelling, fluid, thinning, or scarring caused by choroiditis, especially in the macula. OCT is also useful to monitor response to treatment.
18. Fundus fluorescein angiography (FFA)
FFA uses a fluorescent dye injected into a vein and a special camera to capture images as the dye passes through retinal and choroidal vessels. In choroiditis, FFA can show leaking, blocked, or abnormal vessels and can highlight active lesions and areas at risk of new blood vessel growth.
19. Indocyanine green angiography (ICGA)
ICGA uses a different dye that better shows the choroidal circulation. It is particularly helpful in diseases where choroidal vessels are mainly affected, such as birdshot and serpiginous choroiditis, and can reveal more lesions than are visible on regular exam.
20. Ocular ultrasound (B-scan) and other imaging (CT/MRI, chest X-ray)
B-scan ultrasound can be useful when the view into the eye is cloudy, showing thickening of the choroid, fluid, or masses. CT or MRI of the brain and orbits may be ordered if tumour or neurological disease is suspected. Chest X-ray or CT can look for TB or sarcoidosis when choroiditis appears related to these systemic conditions.
Non-Pharmacological Treatments for Choroiditis
These options do not replace medical treatment. They support healing and protect your eyes alongside the medicines your doctor prescribes.
Eye rest and light control
Resting the eyes (short breaks from reading, screens, and bright light) helps reduce discomfort and photophobia (light sensitivity). Using dim, soft light and closing the eyes for a few minutes several times a day reduces strain on the inflamed tissues.[4]Sunglasses and UV protection
Large, wraparound sunglasses with UV protection and a wide-brim hat reduce bright light entering the eye, which can lower pain and glare in choroiditis. This protection also helps prevent further light-induced stress on the retina and choroid.[5]Avoiding contact lenses during active inflammation
Contact lenses can irritate the surface of the eye and make inflammation or infection worse. During active choroiditis or uveitis, doctors usually advise glasses instead of lenses to reduce mechanical irritation and lower infection risk.[6]Cold or cool compress around the eye
A clean, cool (not ice-cold) compress placed gently on the closed eyelids can decrease pain and a feeling of heat. Cooling causes mild blood-vessel constriction and may reduce superficial swelling and discomfort. Always keep the cloth very clean.[7]Good sleep and body rest
Adequate sleep (usually 7–9 hours for adults) helps the immune system work in a balanced way. Poor or short sleep can worsen inflammation in the body, including the eye, and may slow recovery from choroiditis.[8]Stress management and relaxation
Chronic stress increases stress hormones that can push the immune system toward more inflammation. Deep breathing, gentle yoga, mindfulness, or prayer can calm the nervous system and may indirectly lower inflammatory activity that affects the eye.[9]Healthy physical activity (doctor-approved)
Moderate exercise such as walking improves circulation and overall immune balance. For people with autoimmune diseases related to choroiditis, regular gentle movement can support heart health and lower systemic inflammation, as long as the ophthalmologist and physician say it is safe.[10]Blood pressure and blood sugar control
High blood pressure and diabetes damage small blood vessels in the eye and can make choroid and retinal problems worse. Strict control of blood pressure and glucose with lifestyle and medicines helps protect the delicate blood supply of the retina and choroid.[11]Smoking cessation
Smoking increases systemic inflammation, constricts blood vessels, and raises the risk of many retinal diseases. Stopping smoking improves blood flow to the eye and may reduce the risk of complications of choroiditis and other eye conditions.[12]Limiting alcohol intake
Heavy alcohol use harms the liver, raises inflammation, and may interfere with many drugs used in choroiditis (especially immunosuppressants). Keeping alcohol very low or stopping completely helps drugs work better and lowers risk of toxicity.[13]Balanced anti-inflammatory diet
A diet rich in vegetables, fruits, whole grains, nuts, fish, and healthy oils gives antioxidants and omega-3 fats that support retinal and vascular health. This pattern may help reduce systemic inflammation that contributes to uveitis and choroiditis.[14]Eye-safe screen habits
Long, intense screen use can worsen eye strain and light sensitivity. Using the “20-20-20 rule” (every 20 minutes look 20 feet away for 20 seconds), lowering screen brightness, and using night-mode can reduce discomfort.[15]Proper hygiene to prevent infections
Regular handwashing, avoiding rubbing the eyes, and safe food and water practices reduce the chance of infections like toxoplasmosis or viral illnesses that can trigger infectious choroiditis.[16]Vaccination where appropriate
Vaccines against certain infections (for example, measles, varicella, influenza, COVID-19) can lower the risk of systemic infections that sometimes involve the eye. People on immunosuppressants must follow their doctor’s specific vaccine plan.[17]Protective eyewear at work or in sports
Safety glasses or goggles help prevent trauma and foreign bodies entering the eye. Trauma can trigger inflammation or complicate existing choroiditis, so prevention is important for people doing manual work or contact sports.[18]Artificial tears for surface comfort
Lubricating eye drops (without redness-removing drugs) can relieve dryness and burning, which often accompany uveitis and choroiditis. They do not treat the inflammation inside the eye but improve comfort and blinking.[19]Allergen and irritant avoidance
For patients whose systemic or ocular inflammation worsens with allergies, reducing exposure to smoke, dust, strong perfumes, and other triggers can lower extra irritation and eye rubbing, which is helpful for healing.[20]Patient education and symptom diary
Writing down symptoms, triggers, and medication times helps patients notice early flares of choroiditis and seek prompt care. Education about warning signs makes people more likely to return quickly if vision changes.[21]Mental-health support and support groups
Chronic eye disease is stressful and frightening. Talking with counselors or joining uveitis/choroiditis support groups reduces anxiety and improves treatment adherence, which indirectly protects the eyes.[22]Strict adherence to prescribed medical plan
Carefully following all medicine schedules, lab tests, and follow-up visits is one of the strongest “non-drug” protections. Regular monitoring helps doctors adjust treatment before serious eye damage occurs.[23]
Drug Treatments for Choroiditis
Never start any of these medicines on your own. Most are strong immunosuppressive or anti-infective drugs and need close specialist supervision, blood tests, and sometimes hospital care.
Prednisone (oral corticosteroid)
Prednisone is a strong anti-inflammatory steroid tablet often used as first-line treatment for non-infectious choroiditis and uveitis. Doses are very individual (commonly 0.5–1 mg/kg/day, then slowly reduced) and must be tapered to avoid adrenal problems. Side effects include weight gain, high blood sugar, blood-pressure rise, mood changes, bone loss, and infection risk.[24]Prednisolone acetate eye drops
Prednisolone acetate is a steroid eye drop that fights inflammation in the front of the eye and may complement systemic treatment. Drops are given many times per day at first, then reduced as the eye quiets. Long-term use can raise eye pressure and cause cataracts, so pressures must be checked regularly.[25]Methylprednisolone intravenous pulses
For very severe or sight-threatening choroiditis, doctors sometimes use high-dose IV methylprednisolone for a few days, then switch to oral steroids. This gives a rapid anti-inflammatory effect to save vision but also carries high risk of infection, blood-sugar spikes, and mood or sleep changes.[26]Dexamethasone intravitreal implant (Ozurdex)
Ozurdex is a tiny dexamethasone steroid implant injected into the eye. It slowly releases steroid over several months and is FDA-approved for non-infectious uveitis of the posterior segment. Typical dosing is one implant placed in the eye under sterile conditions. Risks include cataract, eye-pressure rise, and rare infection.[27]Fluocinolone acetonide intravitreal implant (Yutiq / Retisert)
Fluocinolone implants are long-acting steroid devices placed surgically or injected into the eye to prevent recurrent non-infectious uveitis. They can give drug for up to 3 years, greatly reducing relapses but frequently causing cataracts and glaucoma, so careful monitoring is essential.[28]Mycophenolate mofetil
Mycophenolate is an antimetabolite immunosuppressant used as a steroid-sparing agent in chronic non-infectious uveitis. Many adults take around 500–1000 mg twice daily, with dose adjusted by specialists. It works by blocking lymphocyte proliferation. Side effects include stomach upset, low blood counts, and infection risk.[29]Azathioprine
Azathioprine is another antimetabolite used for chronic ocular inflammation when steroids alone are not enough. It interferes with DNA synthesis in immune cells. Dosing is weight-based and adjusted by blood tests. Side effects include bone-marrow suppression, liver toxicity, nausea, and long-term cancer risk, so close monitoring is mandatory.[30]Methotrexate
Methotrexate, at low weekly doses, is widely used for autoimmune uveitis as a steroid-sparing drug. It reduces immune cell proliferation and inflammatory signals. Typical dosing is once weekly with folic acid support, never daily. Side effects include liver toxicity, mouth ulcers, and bone-marrow suppression, so regular labs are needed.[31]Cyclosporine
Cyclosporine is a calcineurin inhibitor that reduces T-cell activation. It is used in difficult uveitis and choroiditis, often together with other agents. Doses are weight-based and adjusted to blood levels. It can cause kidney damage, high blood pressure, tremor, and gum overgrowth, so frequent monitoring is required.[32]Tacrolimus
Tacrolimus is another calcineurin inhibitor used when cyclosporine is not effective or not tolerated. Studies show it can control posterior uveitis at relatively low doses, often around 0.1–0.16 mg/kg/day divided twice daily, but the exact dose is individualized. Main risks include kidney damage, high blood pressure, tremor, and infection.[33]Adalimumab (and biosimilars)
Adalimumab is a biologic anti-TNF antibody approved for non-infectious intermediate, posterior, and pan-uveitis. It blocks TNF-alpha, a key inflammatory signal. A common adult regimen is an 80 mg loading dose under the skin, then 40 mg every 2 weeks, adjusted by specialists. Side effects include serious infection and rare demyelinating disease or malignancy.[34]Infliximab (and biosimilars)
Infliximab is an intravenous anti-TNF antibody used off-label for severe or refractory uveitis and choroiditis, especially with systemic autoimmune disease. Infusions are given in hospital at set intervals (for example, weeks 0, 2, 6, then every 6–8 weeks). It can cause infusion reactions, infection, and rare serious complications.[35]Cyclophosphamide
Cyclophosphamide is a very strong alkylating agent reserved for the most severe autoimmune uveitis or choroiditis, often with systemic vasculitis. It suppresses rapidly dividing immune cells but has high toxicity, including bone-marrow failure, infertility, hemorrhagic cystitis, and cancer risk, so it is used with extreme caution and strict monitoring.[36]Chlorambucil
Chlorambucil is another alkylating drug occasionally used for chronic, difficult uveitis or serpiginous choroiditis when other options fail. It can induce long-term remission but carries serious risks of bone-marrow suppression, infertility, and secondary cancers, so it is limited to selected cases.[37]Valganciclovir
Valganciclovir is an antiviral drug used for cytomegalovirus (CMV) retinitis and related chorioretinal infections. It is converted to ganciclovir in the body and blocks viral DNA replication. Doses are adjusted for kidney function. It can cause low white cells, anemia, and kidney toxicity, so regular labs are required.[38]Ganciclovir (IV or ophthalmic)
Ganciclovir can be given by vein, as an intraocular injection/implant, or as an eye gel for some viral infections. It is a key drug for CMV retinitis but also used for other herpes-family eye infections. Side effects include bone-marrow suppression and kidney damage.[39]Trimethoprim-sulfamethoxazole (co-trimoxazole)
This antibiotic combination is widely used for toxoplasma chorioretinitis, often with folinic acid and sometimes other agents. It blocks folate pathways in bacteria and parasites. Main side effects are allergy, skin rashes, bone-marrow suppression, and kidney or electrolyte problems.[40]Voriconazole
Voriconazole is a broad-spectrum antifungal medicine, given orally or by vein, and sometimes used for fungal chorioretinitis. It blocks fungal ergosterol synthesis. Important side effects include liver toxicity, visual disturbances, and many drug interactions.[41]Foscarnet
Foscarnet is an antiviral used for resistant CMV infections of the retina in immunocompromised patients. It directly inhibits viral DNA polymerase. It is given IV and can cause kidney damage and electrolyte imbalances, so it requires hospital-level monitoring.[42]Combination therapy (steroid + immunosuppressant/biologic)
In many serious choroiditis cases, best results come from combining a steroid with an immunosuppressant or biologic (for example, prednisone plus mycophenolate, or plus adalimumab) to control inflammation and then lowering the steroid. This strategy can preserve vision while limiting steroid side effects.[43]
Dietary Molecular Supplements
Supplements must be checked with your doctor, especially if you are pregnant, very young, elderly, or taking other medicines.
Omega-3 fatty acids (EPA and DHA)
Omega-3s from fish oil or algae support retinal cell membranes and have anti-inflammatory effects. Typical doses in studies for eye health are around 500–1000 mg combined EPA+DHA daily, but exact dosing should be individualized. They may reduce chronic inflammation and support tear and retinal health.[44]Lutein
Lutein is a yellow carotenoid that builds up in the macula and filters blue light. In AREDS-type formulas, 10 mg daily is common. It may help protect photoreceptors from oxidative damage and support long-term retinal health, though it does not directly “cure” choroiditis.[45]Zeaxanthin
Zeaxanthin works with lutein as “macular pigment.” Many eye formulas use around 2 mg daily. It helps absorb harmful light and neutralize free radicals in the retina, supporting overall eye health in long-term inflammatory or degenerative conditions.[46]Vitamin C (ascorbic acid)
Vitamin C is a water-soluble antioxidant that protects eye tissues from oxidative stress. The AREDS formula used 500 mg daily. It helps regenerate vitamin E and supports collagen in blood-vessel walls, which may indirectly support choroidal circulation.[47]Vitamin E
Vitamin E is a fat-soluble antioxidant that protects cell membranes from free-radical damage. AREDS used 400 IU daily. Because it can increase bleeding risk at very high doses or with blood thinners, dosing must be decided with a doctor.[48]Zinc (with copper)
Zinc is important for retinal enzyme systems. In AREDS, 80 mg of zinc oxide plus 2 mg copper daily reduced progression of advanced AMD. Copper is added to prevent deficiency. Long-term high doses can cause stomach upset and low copper, so supervision is needed.[49]Vitamin D
Low vitamin D levels are linked with a higher risk of non-infectious uveitis and more active disease. Supplement doses vary widely depending on blood level and must be guided by tests; many adults use 800–2000 IU daily under medical advice. Too much vitamin D can be toxic, so lab monitoring is important.[50]Curcumin (from turmeric)
Curcumin is a natural compound with anti-inflammatory effects that may modulate NF-κB and other inflammatory pathways. It is often given in enhanced-absorption capsules (for example, 500–1000 mg/day in divided doses), but exact dosing is not standardized. Curcumin can interact with blood thinners, so medical advice is needed.[51]Resveratrol
Resveratrol, found in grapes and berries, has antioxidant and anti-inflammatory actions in experimental retinal models. Supplements commonly contain 100–250 mg, but strong clinical data in choroiditis are limited, so it should be viewed as supportive, not primary therapy.[52]Alpha-lipoic acid or Coenzyme Q10 (CoQ10)
These mitochondrial antioxidants may support nerve and retinal cell energy metabolism and reduce oxidative stress. Doses of 100–300 mg/day are often used in studies of other eye and nerve diseases. They can affect blood sugar and interact with other drugs, so supervision is needed.[53]
Immune-Modulating and Regenerative / Stem-Cell-Related Approaches
These are advanced therapies. Some are standard immunomodulators; others are experimental.
Adalimumab as immune-modulating biologic
Adalimumab strongly suppresses TNF-alpha, which plays a major role in autoimmune uveitis and choroiditis. By reducing this signal, it can control inflammation while allowing steroid doses to fall. Because it changes immune function, patients must be screened for tuberculosis, hepatitis, and other infections before and during therapy.[54]Tocilizumab (IL-6 receptor blocker)
Tocilizumab blocks the interleukin-6 receptor and is used for some severe ocular inflammatory diseases that do not respond to anti-TNF drugs. Typical adult doses in other diseases use 162 mg weekly or every other week by injection, but uveitis dosing is specialized. Risks include infection, changes in cholesterol and liver tests, and, rarely, bowel perforation.[55]Rituximab (CD20 B-cell depleting antibody)
Rituximab targets CD20 on B lymphocytes and can help in some autoimmune retinopathies or uveitis linked to systemic autoimmune disease. It is given by IV infusion at extended intervals. It can cause severe infusion reactions, hepatitis B reactivation, and progressive multifocal leukoencephalopathy (PML), so it is reserved for selected, very severe cases.[56]Autologous hematopoietic stem cell transplantation (HSCT) – experimental in eye disease
HSCT “resets” the immune system by using the patient’s own stem cells after intensive chemotherapy. It is evidence-based in some systemic autoimmune diseases and has been tried as rescue therapy in rare, refractory autoimmune retinopathy. It carries serious risks, including infection, organ damage, and death, so it is considered only in research or extreme cases.[57]Mesenchymal stem cell (MSC)-based retinal therapy – clinical trials
MSCs from bone marrow or other tissues are being studied in trials for retinal diseases. They may release growth factors, reduce inflammation, and support tissue repair, but long-term safety and benefit are still being investigated. Currently, these therapies are experimental and should only be received in regulated clinical trials.[58]Retinal pigment epithelium (RPE) stem-cell–derived cell therapies – research stage
Early-phase trials are testing stem-cell–derived retinal cells to replace damaged tissue in some retinal diseases. These approaches are highly specialized and not standard care for choroiditis today. They show that in the future, regenerative cell therapy may help eyes damaged by chronic inflammation, but for now they remain experimental.[59]
Surgeries and Procedures
Intravitreal steroid implant placement
Implants such as fluocinolone (Yutiq, Retisert) or dexamethasone (Ozurdex) are placed inside the eye when repeated inflammation threatens vision despite drops and tablets. The procedure is done under local anesthesia with sterile technique. It aims to give long-term local steroid while trying to avoid high systemic doses.[60]Pars plana vitrectomy
Vitrectomy removes the cloudy vitreous gel inside the eye. It is done if there is non-clearing vitreous haze, traction on the retina, or diagnostic need. Removing inflammatory debris can improve vision and allows surgeons to treat membranes or retinal complications.[61]Laser photocoagulation for choroidal neovascularization
If chronic choroiditis leads to abnormal new vessels under the retina, focused laser or other focal treatments may be used to seal leaky vessels. The aim is to prevent bleeding and scar enlargement, though it may cause some local vision loss where laser is applied.[62]Surgery for complications (cataract, glaucoma)
Long-term steroid use and inflammation can cause cataracts or glaucoma. Cataract surgery (lens removal with implant) and glaucoma operations or drainage devices may be needed to restore clearer vision and control eye pressure once inflammation is controlled.[63]Chorioretinal or vitreous biopsy (diagnostic surgery)
In rare, unclear cases, a small sample of tissue or vitreous may be taken for lab tests to rule out infections or cancers that mimic choroiditis. This is done in the operating room and helps guide targeted treatment.[64]
Preventions
Treat systemic infections (like TB, syphilis, HIV) early and completely.
Keep autoimmune diseases (such as sarcoidosis, Behçet’s disease, inflammatory bowel disease) under tight control with your specialists.[65]
Maintain good vaccination status as advised for your age and immune status.
Avoid smoking and second-hand smoke exposure.
Protect eyes from trauma with safety glasses during risky work or sports.
Manage diabetes, blood pressure, and cholesterol well.
Have regular complete eye exams if you have any autoimmune disease or past uveitis.
Follow drug monitoring plans (blood tests, imaging) exactly as scheduled.
Discuss pregnancy plans with your doctors if you have uveitis or are on immunosuppressants.
Seek immediate care if you notice new eye pain, redness, floaters, flashes, or vision loss.[66]
When to See a Doctor
You should see an eye doctor urgently (same day or emergency) if you notice:
sudden blurred or dim vision
a dark curtain over part of your sight
many new floaters or flashing lights
severe eye pain or redness
nausea with severe eye or head pain
You should see an ophthalmologist soon (within a few days) if you have milder but new persistent floaters, mild blurred vision, or light sensitivity that lasts more than a day or two, especially if you have a history of uveitis or autoimmune disease.[67]
If you are a teen or child, a parent or guardian should contact the doctor for you and accompany you to visits.
What to Eat and What to Avoid
Eat: Fatty fish (salmon, sardines) 2–3 times per week for omega-3. Avoid: Very high-mercury fish and deep-fried fast food.[68]
Eat: Green leafy vegetables (spinach, kale) rich in lutein and zeaxanthin. Avoid: Diets with almost no vegetables.
Eat: Colorful fruits and vegetables (berries, oranges, carrots) for antioxidants. Avoid: Excess sugary drinks and sweets that spike blood sugar.[69]
Eat: Nuts and seeds (walnuts, chia, flax) for healthy fats. Avoid: Trans-fat snacks and heavily processed junk foods.
Eat: Whole grains and legumes for stable energy and fiber. Avoid: Very refined white flour products all day.
Eat: Foods with zinc and copper (beans, seeds, seafood, eggs) as tolerated. Avoid: High-dose zinc or vitamin E supplements without a doctor.
Eat: Adequate protein from fish, lean meats, eggs, or plant proteins to support healing. Avoid: Crash diets or severe calorie restriction during active disease.
Eat: Vitamin-D-rich foods (fortified milk, eggs, oily fish) if appropriate. Avoid: Self-prescribing very high dose vitamin D without blood tests.[70]
Drink: Plenty of clean water; moderate tea or coffee. Avoid: Excess alcohol, energy drinks, and very sugary beverages.
General rule: Aim for a “Mediterranean-style” anti-inflammatory diet pattern and limit ultra-processed foods, which are linked to systemic inflammation that can also affect the eyes.[71]
Frequently Asked Questions
Is choroiditis the same as uveitis?
Choroiditis is a type of posterior uveitis. “Uveitis” means inflammation of the uveal tract (iris, ciliary body, choroid). When the choroid is the main part affected, doctors often say “choroiditis” or “chorioretinitis.”[72]Can choroiditis make me blind?
Yes, if it is severe, untreated, or keeps coming back, choroiditis can cause permanent damage to the retina and serious vision loss. Early diagnosis, strong but careful treatment, and close follow-up greatly reduce this risk.[73]Is choroiditis always caused by infection?
No. Some cases are infectious (for example, toxoplasma, TB, CMV), but many are autoimmune or idiopathic. Doctors must do blood tests, imaging, and sometimes biopsy to find the cause before choosing treatment.[74]How long does treatment usually last?
Many people need months to years of treatment and careful tapering of medicines to avoid relapse. Chronic non-infectious choroiditis may require long-term immunosuppressive or biologic therapy to keep the disease quiet.[75]Are steroid eye drops alone enough?
For deep posterior disease like choroiditis, drops alone are usually not enough. Most patients need oral, injected, or implanted medicines to reach the back of the eye.[76]Why do I need blood tests so often?
Many drugs used in choroiditis (like mycophenolate, methotrexate, azathioprine, cyclophosphamide, biologics) can affect blood counts, liver, or kidneys. Regular blood tests catch problems early so doses can be adjusted safely.[77]Can diet alone cure choroiditis?
No. Diet and supplements may support general eye and immune health but cannot replace anti-infective or immunosuppressive treatment. Relying only on food or herbal remedies can lead to permanent vision loss.[78]Is it safe to stop medicines when I feel better?
Stopping medicines suddenly can cause a rebound flare that is sometimes worse than the first attack. Any tapering or stopping should be slow and always guided by your ophthalmologist or rheumatologist.[79]Can children or teens get choroiditis?
Yes. Some infections and autoimmune diseases in children can involve the choroid. Treatment in young people must be handled by pediatric specialists because eye growth and systemic side effects need special care.[80]Will I always need steroids?
Many patients start with steroids, then switch to or add steroid-sparing drugs so that the steroid dose can be lowered or sometimes stopped. The goal is to control inflammation with the lowest long-term steroid use possible.[81]Are biologic drugs more dangerous than older drugs?
Biologics have different risks, mainly serious infections and rare immune or neurologic reactions. Older drugs like cyclophosphamide can also be very toxic. The safest option depends on your exact disease, age, and other health issues, which your specialist will weigh carefully.[82]Can I use over-the-counter eye drops for pain?
Lubricating drops are usually safe, but “redness-removing” drops or steroid-containing drops without prescription can hide symptoms and delay proper care. Always show any planned OTC product to your eye doctor first.[83]Do I need to avoid pregnancy if I have choroiditis?
Many drugs used for uveitis (methotrexate, mycophenolate, cyclophosphamide) can harm a fetus and must be stopped well before pregnancy. Women and men with choroiditis should discuss family planning very early with their doctors.[84]Can choroiditis come back after years of quiet?
Yes, some forms are relapsing. Even after long remission, new systemic triggers or stopping medication can cause recurrence. That is why regular eye check-ups remain important even when you feel well.[85]What is the most important thing I can do today?
The most important step is early, specialist-guided care. If you suspect choroiditis or have known disease with new symptoms, contact your ophthalmologist quickly, take medicines exactly as prescribed, and keep all follow-up visits and blood tests.[86]
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members
Last Updated: January 15, 2026.
