CONCLUSION: Atypical presentations of serpiginous choroiditis can cause diagnostic dilemma, but prompt diagnosis and immediate treatment can result in good visual recovery. [ncbi.nlm.nih.gov]

We present a case of serpiginous choroiditis refractory to steroids, immunosuppressants, and adalimumab. CASE PRESENTATION: An 18-year-old woman presented with severe vision loss in both eyes. [read.qxmd.com]

• Noncompliance

  Our patient lacked systemic therapy for the first 11 months because of noncompliance. The case is remarkable as the delayed onset of peripheral lesions and the additional existence of high myopia made diagnosis difficult. [ncbi.nlm.nih.gov]

  Our patient lacked systemic therapy for the first 11 months because of noncompliance. Conclusions The case is remarkable as the delayed onset of peripheral lesions and the additional existence of high myopia made diagnosis difficult. [jmedicalcasereports.biomedcentral.com]

• Internal Bleeding

  Conclusion Different MFC lesions exhibit different symptoms such as inflammation, internal bleeding, invasion of the RPE and choroidal scar. These symptoms can be detected by comprehensive optical examinations. [bmcophthalmol.biomedcentral.com]

• Streptococcal Infection

  There has been a case of APMPPE after streptococcal infection. 34 ANCILLARY TESTING Fluorescein The classic findings in the acute cases are lesions of variable size that are hypofluorescent in the early phase of the fluorescein angiogram. [entokey.com]

• Osteopenia

  Oral corticosteroids are not without significant side effects, including risk of systemic hypertension, diabetes mellitus, hypercholersterolemia, weight gain/ obesity, insomnia, anxiety, and osteopenia. [reviewofophthalmology.com]

• Scotoma

  A patient affected by MFC complaining central visual loss and scotoma in his left eye was fully investigated with dye-based angiographies, structural OCT and OCT-A. [ncbi.nlm.nih.gov]

  […] reports a 2 day history of a new scotoma noticed on Amsler Grid testing of his right eye. [webeye.ophth.uiowa.edu]

  & Retina › Infectious / Inflammatory Disorders › Rare, chronic, bilateral inflammatory disorder Recurrences are common Onset is usually between ages 30 and 70 years Clinical features: Symptoms: Painless blurring of vision with central or paracentral scotoma [dro.hs.columbia.edu]

• Corneal Infiltrate

  Biomicroscopy MULTIFOCAL CHOROIDITIS Anterior Segment Findings If there are corneal infiltrates then there should be consideration that the multifocal choroiditis is caused by Epstein-Barr virus. [entokey.com]

Our patient presented with a suspicious intraocular mass that was diagnosed as SIC after an extensive ocular examination and laboratory workup was completed. [ncbi.nlm.nih.gov]

Differential Diagnosis and Workup The differential diagnosis for MFC and PIC can be extensive (See Table of Differential Diagnosis). [reviewofophthalmology.com]

Workup with serum angiotensin-converting enzyme, serum calcium and a chest radiograph also showed no arguments for sarcoidosis. [karger.com]

• Mycobacterium Kansasii

  We report here a case with resistant post-operative inflammation that presented with occult ICGA-detected choroiditis and a positive IGRA test that was most probably due to the non-tuberculous mycobacterium (NTM) Mycobacterium kansasii. [ncbi.nlm.nih.gov]

• HLA-A3

  HLA typing showed the patient to be HLA-A3, -A28, -B51(5), -Bw4, -Bw6, and -B35 positive. Results of serologic testing for syphilis were negative. Values for serum angiotensin-converting enzyme were within normal limits. [jamanetwork.com]

Treatment - monotherapy: ciclosporin or triple therapy: systemic steroids, azathioprine and ciclosporin; stem cell treatment[10]. [patient.info]

Treatment with oral prednisolone at 30 mg daily with topical prednisolone acetate 1% every 2 hours were prescribed, which were gradually tapered down within a 2-month course. [ncbi.nlm.nih.gov]

To date, there is no established consensus on treatment protocol. This article presents a case report of macular serpiginous choroiditis and reviews supporting data for immunosuppressive treatment plans. [read.qxmd.com]

Prognosis - this condition recurs over months and frequent foveal involvement gives rise to a relatively poor prognosis. Multiple evanescent white dot syndrome (MEWDS) Nature - uncommon, idiopathic and self-limiting condition. [patient.info]

Prognosis and Outcomes The long-term visual prognosis of both MFC and PIC is variable and is largely dependent upon the development of refractory CME and CNVM. [reviewofophthalmology.com]

(Outcomes/Resolutions) The prognosis of Serpiginous Choroiditis generally varies between individuals. In many cases, the prognosis is difficult to predict Also, the prognosis depends upon the severity of the signs and symptoms. [dovemed.com]

[…] among selected white dot syndromes (WDS) (birdshot chorioretinopathy (BRC), multifocal choroiditis, serpiginous choroidopathy (SC), and others) and to identify risk factors of poor visual prognosis. [read.qxmd.com]

To report on ampiginous choroiditis of tubercular etiology with nPCR positivity for M. tb in aqueous sample and also to stress upon the usefulness of nPCR to consolidate the etiological diagnosis. [ncbi.nlm.nih.gov]

Tuberculous etiology has been suspected in cases of SC since 1952.2-4,16 In patients from areas endemic for tuberculosis, Gupta and colleagues5 described SLC of presumed tubercular etiology that mimicked SC. [jamanetwork.com]

This patient tested positive for QuantiFERON-TB Gold, suggesting mycobacteria as the etiology for the multifocal choroiditis. [joii-journal.springeropen.com]

EPIDEMIOLOGY Most cases affect young persons both men and women between the ages of 20 and 40 years. There has been an association with other diseases as noted below. [entokey.com]

Diagnosis : Serpiginous Choroiditis (Geographic helicoid peripapillary choroidopathy) EPIDEMIOLOGY Middle-aged individuals (30-60 yrs, usually) No distinct gender nor race predilection (possible slight male preponderance) No genetic factors identified [webeye.ophth.uiowa.edu]

The 2009 prospective multi-center epidemiologic survey of uveitis in Japan. Jpn J Ophthalmol 2012;56:432-5. 9. Rathinam SR, Namperumalsamy P. Global variation and pattern changes in epidemiology of uveitis. Indian J Ophthalmol 2007;55:173-83. [ijo.in]

Epidemiology and Clinical Signs Multifocal choroiditis (MFC) presents most frequently in female patients with an age range of 6 to 69 years, with the average age of presentation in the fourth decade of life. [reviewofophthalmology.com]

Epidemiology of HIV-associated cryptococcosis in France (1985-2001): comparison of the pre- and post-HAART eras. AIDS. 2004;18:555-562. 6. Okun E, Butler WT. Ophthalmologic complications of cryptococcal meningitis. Arch Ophthalmol. 1964;71:52. 7. [retinalphysician.com]

OCTA may be an effective noninvasive image modality to follow up these patients and may provide further information to help us to understand the pathophysiology and complications of these diseases. [ncbi.nlm.nih.gov]

Offers the most comprehensive content available on retina, balancing the latest scientific research and clinical correlations, covering everything you need to know on retinal diagnosis, treatment, development, structure, function, and pathophysiology. [books.google.com]

CONCLUSIONS: Eyes with choroiditis of suspected/presumed tubercular origin should be subjected to PCR for diagnosis of TB and subjected to ATT for prevention of recurrences. [ncbi.nlm.nih.gov]

[…] eye Causes - Choroiditis * Toxocariasis * Cytomegalovirus * Presumed ocular histoplasmosis syndrome * Herpes virus 2 * Histoplasmosis * Syphilis, congenital * Herpes simplex * Toxoplasma * Krill retinal pigment epitheliitis * Toxoplasma, congenital Prevention [checkorphan.org]

Successful resolution did not prevent recurrence of the disease. There is need for periodic follow-up and self-examination of central vision by Amsler chart in this disease. [eophtha.com]