This study reported the five-year outcomes of chorioretinal atrophy (CRA) progression in patients with punctate inner choroidopathy (PIC) or multifocal choroiditis (MFC) in 45 eyes of 36 patients. The mean age of the cohort of patients was 37 ±13.37 years with a mean spherical equivalent of -7.94 ±3.70D and a mean axial length of 28.09 ±2.06mm. The mean CRA area increased significantly from 1.9 ±3.80 mm2 to 4.98 ±5.72 mm2 (P<0.001) equating for an overall mean CRA progression rate of 0.69 ±0.89 mm2/year. There was no significant change in logMAR best-corrected visual acuity (BCVA) and visual field (VF) defect values over the follow-up period (both P>0.05). On univariate and multivariate linear regression analysis, axial length and lesion number were associated with CRA progression (P=0.018 and P=0.006, respectively). Patients were also categorised as “oligo-spots” if they had less than four chorioretinal lesions at initial presentation and “multi-spots” if they presented with more than four lesions. “Multi-spot” patients exhibited greater rate of recurrence, CRA enlargement, development of zonal outer retinopathy and worse VF defect value compared to “oligo-spots”. Given these findings, the authors suggest more aggressive anti-inflammatory regimen and closer follow-up for patients with greater chorioretinal lesions to prevent CRA progression and long-term visual impairment.