Abstract
PURPOSE: To describe a rare case of relentless placoid chorioretinitis (RPC) associated with Crohn's disease, complicated by secondary multiple evanescent white dot syndrome (MEWDS). OBSERVATIONS: A 21-year-old man presented with acute, painless vision loss in the right eye. Multimodal retinal imaging showed numerous active and atrophic placoid lesions involving both the posterior pole and the retinal periphery, consistent with RPC. Systemic evaluation revealed Crohn's disease. Despite intravenous and oral corticosteroids, new extramacular lesions developed and fundus autofluorescence showed stippling compatible with secondary MEWDS. Introduction of anti-tumor necrosis factor (anti-TNF) therapy for Crohn's disease stabilized ocular inflammation. Visual prognosis remained poor in the affected eye and preserved in the fellow eye. CONCLUSIONS AND IMPORTANCE: This case highlights an association between RPC and Crohn's disease and supports an autoimmune mechanism. Early systemic evaluation and timely initiation of corticosteroid-sparing immunomodulatory therapy may help prevent recurrences and vision-threatening complications.