Presentation
CONCLUSIONS: The present study details the clinical presentation, treatment, and visual outcome of serpiginous choroiditis. Mantoux test reading does not affect the clinical presentation or the treatment outcome in these eyes. [ncbi.nlm.nih.gov]
Immune System
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Mediastinal Lymphadenopathy
His investigation revealed strongly positive tuberculin skin test with ulceration (24 mm induration); positive Quantiferon TB-Gold Test and contrast enhanced computed tomography chest revealed mediastinal lymphadenopathy (necrotic lymph nodes without [peertechz.com]
Respiratoric
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Chronic Cough
cough, chest pain and haemoptysis to exclude active infection. [13] History of other systemic symptoms is required to exclude extrapulmonary TB; presence of abnormal physical signs suggestive of TB should be looked for. [13],[21] Presumed ocular TB, [saudijhealthsci.org]
Eyes
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Retinal Cyst
The fovea is seen to be highly distorted, with a small intraretinal foveal cyst and a number of other outer retinal cysts. [tandfonline.com]
Face, Head & Neck
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Facial Swelling
Click here to view The patient complained of facial swelling and leg pitting edema after 3 weeks of steroid treatment, so we tapered prednisolone gradually. [e-tjo.org]
Urogenital
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Testicular Swelling
The patient gave a history of testicular swelling for the past 2 years. [ncbi.nlm.nih.gov]
Workup
Patients with SC were from areas nonendemic for tuberculosis, had negative uveitis workup findings (including tuberculin skin test results), and were successfully managed with steroids/immunosuppressive agents (follow-up, 6-72 months) with no recurrence [ncbi.nlm.nih.gov]
Workup with serum angiotensin-converting enzyme, serum calcium and a chest radiograph also showed no arguments for sarcoidosis. [karger.com]
Uveitis workup findings were negative in all cases except for a positive TST result, with the chest radiograph being invariably normal. [jamanetwork.com]
We did extensive workup to exclude tuberculosis in our case, since the management differs significantly. [omicsonline.org]
X-Ray
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Normal Chest X-Ray
Although majority of patients with presumed tubercular MSC have normal chest X-ray and do not have any evidence of systemic focus elsewhere [ 10, 12 ], chest X-ray is a routine test ordered in uveitis practice. [entokey.com]
Microbiology
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Toxoplasma Gondii
Serpiginous choroiditis-like picture can be an atypical manifestation of ocular Toxoplasma gondii infection. [ncbi.nlm.nih.gov]
An ampiginous-like case report showed positive serology in blood and polymerase chain reaction (PCR) in aqueous humour for Toxoplasma gondii infection. [karger.com]
In Toxoplasma gondii -associated SC, multifocal, confluent lesions have been described in the posterior pole as well as the periphery [ 44 ]. [entokey.com]
However, antiviral therapy has not been reported to have any beneficial role in treatment of SC and there are reports of disease recurrence in spite of antiviral therapy.[34] Toxoplasma gondii has also been implicated as possible etiological agent.[35 [ijo.in]
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Bartonella Henselae
We describe herein the first 2 reported cases to date of SC secondary to Francisella tularensis and Bartonella henselae. [jamanetwork.com]
Bartonella henselae has been reported to cause unilateral, macular subretinal lesions without anterior segment involvement [ 48 ]. [entokey.com]
henselae e also been reported to cause serpiginous choroiditis. [11] Positive serology for Herpes simplex virus in patients with serpiginous choroiditis had fueled the speculation of viral etiology, but histopathology study with polymerase chain reaction [ijo.in]
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Human Papillomavirus
A case of ampiginous choroiditis following a human papillomavirus vaccine was reported, although a causal relationship is not sure [ 7 ]. [karger.com]
She received vaccination for human papillomavirus 3 years ago. The best corrected visual acuity was 20/22 in both eyes. The anterior segment examination was unremarkable in both eyes. [bmcophthalmol.biomedcentral.com]
Other Pathologies
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Diffuse Vasculitis
Immunological studies revealed no signs of diffuse vasculitis. Of the histocompatibility antigens, HLA-A2 was found in five and HLA-B7 in 4 of the 6 patients studied. [ncbi.nlm.nih.gov]
Immunological studies revealed no signs of diffuse vasculitis. Of the histocompatibility antigens, HLA‐A2 was found in five and HLA‐B7 in 4 of the 6 patients studied. [onlinelibrary.wiley.com]
Treatment
To determine the efficacy of immunosuppressive treatment in serpiginous choroiditis. [ncbi.nlm.nih.gov]
Prognosis
Many times, fundus autofluorescence is the investigation which is guiding the diagnosis, the management, also the follow-up together with the determination of the progressive visual prognosis. [ncbi.nlm.nih.gov]
Eyes with macular serpiginous choroiditis often had a poor visual prognosis and sometimes developed subretinal neovascularization. [scholars.northwestern.edu]
Conclusions: Adequate immunosuppression with alkylating agents may favorably alter the long-term prognosis of patients with serpiginous choroiditis. [jhu.pure.elsevier.com]
Etiology
Multiple etiologies including autoimmunity, infection, vasculopathy, and degeneration were proposed but none is well supported by clinical and laboratory evidence. [ncbi.nlm.nih.gov]
Epidemiology
[…] of serpiginous choroiditis. 61 Dutta Majumder P...Gupta A 30777946 2019 9 SERPIGINOUS CHOROIDITIS IMAGED BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. 61 El Ameen A...Herbort CP 28033230 2018 10 An update on inflammatory choroidal neovascularization: epidemiology [malacards.org]
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 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]
It generally constitutes less than 5% of posterior uveitis in most epidemiological reports (2). The disease primarily affects healthy young to middle-aged adults, with a higher prevalence reported in males than females (3). [studyres.com]
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]
The pathophysiology of presumed tuberculous serpiginouslike choroiditis is unknown. [retina.com.au]
No systemic disease associations have been identified. [4] Pathophysiology Although of unknown etiology, its origin is probably immunogenic since it seems to respond to treatment with corticosteroids and other immunosuppressants. [eyewiki.aao.org]
Prevention
Proximity of the membrane to the foveal avascular zone prevented photocoagulation of the neovascular membrane in one patient. Central visual acuity remained 6/60 (20/200) despite systemic corticosteroid therapy. [ncbi.nlm.nih.gov]