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]
Skin
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Subcutaneous Nodule
Additional findings may include optic disc edema and episcleritis. [9, 10] Associated findings APMPPE has been associated with erythema nodosum, a vasculitic condition that consists of painful subcutaneous nodules in the axilla and lower extremities. [emedicine.medscape.com]
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]
Several imaging tests (including chest x-ray, computed tomography scan, and magnetic resonance imaging), lumbar puncture, bone marrow aspirate, and extensive serologic workup (including a second TB-specific interferon gamma test) were performed with negative [aaojournal.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]
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]
(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]
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 11 SERPIGINOUS CHOROIDITIS IMAGED BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. 61 El Ameen A...Herbort CP 28033230 2018 12 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]
[…] great for detecting subtle peripheral lesions Color fundus photography Fluorescein angiography Indocyanine green angiography Amsler grid Monitor for choroidal neovascularization (CNV) 13-35% rate of occurrence Clinical exam, OCT, fluorescein angiography Pathophysiology [eye.keckmedicine.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]