Case ReportFOVEAL OUTER RETINAL HYPERREFLECTIVITY: A NOVEL OPTICAL COHERENCE TOMOGRAPHY FINDING IN IDIOPATHIC MULTIFOCAL CHOROIDITISDolz-Marco, Rosa MD, PhD*,†,‡; Kalevar, Ananda MD§,¶; McDonald, H. Richard MD§,¶; Cunningham, Emmett T. Jr MD, PhD§,¶,**,††; Freund, K. Bailey MD*,†,‡‡,§§Author Information *Unit of Macula, Oftalvist Clinic, Valencia, Spain; †Vitreous, Retina, Macula Consultants of New York, New York, New York; ‡LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York; §West Coast Retina Medical Group, San Francisco, California; ¶Department of Ophthalmology, California Pacific Medical Center, San Francisco, California; **Francis I. Proctor Foundation, University of California San Francisco, San Francisco, California; ††Department of Ophthalmology, Stanford University School of Medicine, Stanford, California; ‡‡Department of Ophthalmology, Edward S Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, New York; and §§Department of Ophthalmology, New York University School of Medicine, New York, New York. Reprint requests: K. Bailey Freund, Vitreous Retina Macula Consultants of New York, 950 Third Avenue, New York, NY 10022; e-mail: [email protected] Supported by The Macula Foundation Inc, New York, NY. R. Dolz-Marco: Consultant for Heidelberg Engineering. Research support from Genentech, Novartis and Roche; K. B. Freund: Consultant for Genentech, Optos, Optovue, Heidelberg Engineering, Zeiss, Novartis, and Allergan. Research support: Genentech/Roche. The remaining authors have any conflicting interests to disclose. Retinal Cases & Brief Reports: November 2021 - Volume 15 - Issue 6 - p 651-656 doi: 10.1097/ICB.0000000000000878 Buy Metrics AbstractIn Brief Purpose: To describe three patients with idiopathic multifocal choroiditis (MFC) who showed foci of foveal outer retinal hyperreflectivity on optical coherence tomography. Methods: Retrospective review of electronic health records and multimodal imaging from three patients with MFC. Results: Three consecutive white patients with MFC (two male and one female) presented with unilateral foveal outer retinal hyperreflectivity in the eye with active MFC. In all cases, the lesions persisted for at least 1 month. Optical coherence tomography demonstrated finger-like projections of hyperreflectivity extending from the retinal pigment epithelium and through disrupted interdigitation and ellipsoid zones into the outer nuclear layer, with some aspects of the lesions reaching the inner limiting membrane. Visual recovery varied in the three affected eyes. Conclusion: Foveal outer retinal hyperreflectivity is a novel optical coherence tomography finding in eyes with active MFC. Additional studies will be required to address the prevalence and prognostic importance of foveal outer retinal hyperreflectivity. We describe the novel optical coherence tomography finding of foveal outer retinal hyperreflectivity occurring in eyes with idiopathic multifocal choroiditis.