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Choroiditis

Choroiditides


Presentation

  • On presentation, her best corrected visual acuity was 6/60 in the right eye with a prominent anterior uveitis seen under slit lamp examination.[ncbi.nlm.nih.gov]
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]
Lymphadenopathy
  • Case report of a patient presenting with active ampiginous choroiditis with no evidence of systemic TB but had hilar and para-tracheal lymphadenopathy on CT chest.[ncbi.nlm.nih.gov]
Exposure to Horses
  • A 56-year-old asymptomatic female equestrian with an extensive history of exposure to horses and dogs and a trapper of wild animals and rodents was discovered to have an amelanotic choroidal mass in the macular region and referred for suspicious atypical[ncbi.nlm.nih.gov]
Aspiration
  • In 27 controls (patients without uveitis undergoing phacoemulsification), anterior chamber aspirate was done and sample subjected to real-time PCR.[ncbi.nlm.nih.gov]
  • Indeed, most cases of confirmed cryptococcal choroiditis in the literature are from autopsy or enucleation, 10,15,21 although the diagnosis has been confirmed by fine needle aspiration biopsy, 10-11 at vitrectomy, 13 and by retinal biopsy. 14 In addition[retinalphysician.com]
  • The diagnosis is complicated by difficulties obtaining ocular tissue, difficulties isolating the organisms from aqueous aspirates, tests that are neither sensitive nor specific, and the variability in clinical presentation [ 1 ].[joii-journal.springeropen.com]
Vomiting
  • A 30-year-old HIV-positive man presented with fever, headache, vomiting, and altered sensorium Ophthalmological examination revealed bilateral multifocal choroiditis and optic neuropathy.[ncbi.nlm.nih.gov]
Nausea
  • The patient developed severe nausea after starting her antituberculosis medications and immediately stopped taking these medications.[joii-journal.springeropen.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]
Kidney Failure
  • Methotrexate may cause leukopenia and liver damage; cyclosporine use may cause kidney failure; and chlorambucil may lead to significant thrombocytopenia and complete bone marrow failure.[reviewofophthalmology.com]
Headache
  • A 30-year-old HIV-positive man presented with fever, headache, vomiting, and altered sensorium Ophthalmological examination revealed bilateral multifocal choroiditis and optic neuropathy.[ncbi.nlm.nih.gov]
  • An antecedent flu-like illness was noted in 20% of cases and 13% had headaches prior to development of the ocular findings. Approximately 25% of patients had a history of a systemic autoimmune disease.[entokey.com]
  • On review of systems, the patient described intermittent headaches and right eye pain. He denied neck stiffness and subjective fevers or chills. His vital signs were within the normal limits.[retinalphysician.com]
Insomnia
  • 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]

Workup

  • 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]

Treatment

  • In our case, anti-tumor necrosis factor alpha monoclonal antibody therapy represented a valid treatment option in a patient unresponsive to traditional immunosuppressive treatments.[ncbi.nlm.nih.gov]

Prognosis

  • 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]
  • Prognosis - Choroiditis Not supplied. Treatment - Choroiditis Not supplied. Resources - Choroiditis Not supplied.[checkorphan.org]

Etiology

  • 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]
  • Conclusions Multifocal chorioretinal lesions of unknown etiology can present as a diagnostic and therapeutic dilemma.[joii-journal.springeropen.com]
  • In fact, in most cases, the etiology remains unknown; hence the term idiopathic.[retinatoday.com]

Epidemiology

  • 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]
  • 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]
  • Epidemiology of transient ischemic attack and ischemic stroke in patients with underlying cardiovascular disease. Clin Cardiol 2004;27(5 Suppl. 2):II4–11. 10. Mooe T, Eriksson P, Stegmayr B. Ischemic stroke after acute myocardial infarction.[e-tjo.org]
Sex distribution
Age distribution

Pathophysiology

  • 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]

Prevention

  • 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]

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