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Diagnostic Features and Treatment of Serpinginous Choroidopathy
Kraut A., Jaki P.,
University Eye Clinic of Ljubljana (Ljubljana)
Purpose: To show the analysis of the findings in patients treated for serpiginous choroidopathy (SC).
Methods: We observed 5 patients (3 males and 2 females) with SC for 1 to 6 years. Their ages ranged from 50-65 years. Patients were investigated for systemic disease and were examined with fluorescein angiography (FA), indocyanine green angiography (ICGA), and in follow-up temporal fundus photography was done. All patients were treated with anti- tuberculous drugs and prednisolone. In addition, one patient was treated with azathioprine, and one with both azathioprine and cyclosporine A.
Results: All 5 patients fulfilled criteria for SC. Differential diagnosis included acute posterior multifocal placoid pigment epitheliopathy. All five patients had a positive Mantoux test, two of them had previously been treated for tuberculosis. In two patients the recurrence of SC was established while they were under observation. The therapy was successful in arresting the disease, but in one patient the recurrency and spreading into the macula of his better eye required tripple agent therapy.
Conclusions: Clinical presentation, course and FA findings support the diagnosis of SC. ICGA shows the extent of the choroidal involvement, and temporal fundus photographies the progression of the disease. Corticosteroids (with antituberculous drugs) are effective in arresting the disease, but in some cases azathyoprine and cyclosporin A should be recommended.