Clinical features of tuberculous serpiginouslike choroiditis in contrast to classic serpiginous choroiditis

Daniel V. Vasconcelos-Santos, P. Kumar Rao, John B. Davies, Elliott H. Sohn, Narsing A. Rao

Research output: Contribution to journalArticle

75 Scopus citations

Abstract

Objective: To compare distinctive clinical features of presumed tuberculous serpiginouslike choroiditis (Tb-SLC) with classic serpiginous choroiditis (SC) in patients living in a region that is nonendemic for tuberculosis. Methods: Retrospective comparative analysis of clinical features of 5 patients with recurrent Tb-SLC and 5 with SC. Results: All patients with recurrent Tb-SLC primarily emigrated from areas highly endemic for tuberculosis and had been unsuccessfully treated with steroids/immunosuppressive agents. Results of uveitis investigations were negative except for positive tuberculin skin test results. These patients received oral tuberculostatic drugs, without recurrences (follow-up, 6-91 months). The ocular involvement in Tb-SLC was mostly unilateral, with multiple irregular serpiginoid lesions involving the posterior pole and periphery but usually sparing the juxtapapillary area. All 5 cases had inflammatory cells in the vitreous. 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. Ocular involvement in SC was usually bilateral, rarely multifocal, and primarily involved the posterior pole, especially around the optic disc and extending contiguously to the macula. No patient with SC presented with vitritis. Conclusion: In areas nonendemic for tuberculosis, SC can be clinically differentiated from Tb-SLC. Patients with Tb-SLC come from highly endemic regions, show significant vitritis, and often present with multifocal lesions in the posterior pole and periphery. Cases of SC, in contrast, reveal minimal or no vitritis and frequently show bilateral involvement with larger solitary lesions extending primarily from the juxtapapillary area and sparing the periphery.

Original languageEnglish
Pages (from-to)853-858
Number of pages6
JournalArchives of Ophthalmology
Volume128
Issue number7
DOIs
StatePublished - Jul 1 2010

Fingerprint Dive into the research topics of 'Clinical features of tuberculous serpiginouslike choroiditis in contrast to classic serpiginous choroiditis'. Together they form a unique fingerprint.

  • Cite this