Jan 04, 2021 background classic serpiginous choroiditis sc usually begins in the peripapillary area and spreads centrifugally, however, in some patients, the lesion can arise in the macular region. Serpiginous choroiditis sc is a rare, usually bilateral, progressive, recurrent, idiopathic inflammatory disease that primarily affects the inner choroid and. Indocyanine green angiographic findings in serpiginous. It was first described in 1904 by junius but was defined as we now recognize it in the 1970s. If you have problems viewing pdf files, download the latest version of adobe reader. Serpiginous choroiditis presenting after sarscov2 infection. Pdf serpiginous choroiditislike picture due to ocular. This case report describes a woman in her 40s who presented with bilateral, progressive, and blurry vision for 1 month.
The cause is unknown, although tuberculosis should be ruled out in all cases. Interferon alpha2a treatment the right eye and the patient is free from recurrences for serpiginous choroiditis. Serpiginous choroiditis by any other name ophthalmology. We report another case of celiac disease and atp associated with geographic. Although rare, serpiginous choroiditis deserves attention because it can lead to permanent loss of vision due to foveal involvement by inflammation or choroidal neovascularization. Helicoid heredodegeneration of the chorioretina was the name chosen by franceschetti to identify a. Treatment of serpiginous choroiditis with chlorambucil. Serpiginous choroiditis sc is a rare, usually bilateral, progressive, recurrent, idiopathic inflammatory disease that primarily affects the inner choroid and retinal pigment epithelium. Serpiginous choroiditis is a rare inflammatory eye condition that typically develops between age 30 and 70 years. Infliximab in serpiginous choroiditis seve 2010 acta. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means. Results 14 patients presented with serpiginous like choroiditis over 10 years seven within the last 2 years. Retrospective analysis of the natural history and management of serpiginous choroiditis in australia and new zealand. Sep 15, 2020 serpiginous choroiditis is known to be a disorder affecting both eyes without a known etiology.
Pdf retrospective analysis of the natural history and. Chorioretinopathies, known as serpiginous choroiditis, can be divided into three similar entities, each characterized by its own clinical and evolutional peculiarities 1. This is a case of serpiginous choroidopathy with inactive pattern. Serpiginous choroiditis also called geographic helicoid peripapillary choroidopathy is a rare, idiopathic inflammatory disease affecting the inner choroid and retinal pigment epithelium. In a furth patient disc new vessels were seen at the active stage of serpiginous choroiditis. Genetic and rare diseases information center gard po box 8126, gaithersburg, md 208988126 toll free. Serpiginous like choroiditis multifocal choroiditis that progresses to a diffuse, contiguous variety, acquiring an active advancing edge like serpiginous choroiditis diffuse plaquelike choroiditis with amoeboidal spread the 2nd eye may be affected months or years later relentless progression despite systemic corticosteroids and imt. Zohar habotwilner md, susan lightman phd, frcp, frcophth, in retinal pharmacotherapy, 2010. Serpiginous choroiditis like picture can be an atypical.
Helicoid heredodegeneration of the chorioretina was the name chosen by franceschetti to identify a slowly progressing disease affecting young children. Serpiginous choroiditis is a rare idiopathic inflammatory disease. The patient was diagnosed to have healed serpiginous choroiditis in both eyes with inflammatory choroidal neovascular membrane and fce in. To report the first case of a serpiginous choroiditis presenting after sarscov2 infection in a previously healthy young woman. Aim to describe the increasing incidence of multifocal outer retinal and inner choroidal inflammation as a marker for intraocular tuberculosis in the uk, a nonendemic area. Placoid pigment epitheliopathy and serpiginous choroiditis. Serpiginous choroiditis causes, symptoms, diagnosis. Pdf on feb 1, 1994, c edelsten and others published serpiginous choroiditis. Full text get a printable copy pdf file of the complete article 3. Cyclosporinea in the treatment of serpiginous choroiditis.
Serpiginous choroiditis also called geographic helicoid peripapillary choroidopathy. Download pdf serpiginous choroiditis sc is a rare, bilateral, idiopathic inflammatory disorder that results in geographic destruction of the retinal pigment epithelium rpe, retina, and choriocapillaris. Download ebook atlas of uvetis and scleritis pdf free. In total, 17 patients with the diagnosis of serpiginous choroiditis treated with chlorambucil were identified. Ampiginous choroiditis, a variant of serpiginous choroiditis, is a bilateral aggressive posterior uveitis that appears multifocal and placoid in its initial phases but coalesces and shows progression of lesions in its evolution. Serpiginous choroidopathy is a chronic recurring disorder, usually bilateral and asymmetrical, which primarily. Serpiginous choroiditis, also known as geographic or helicoid choroidopathy, is an uncommon chronic progressive inflammatory disease affecting adult men and women equally in the second to seventh decades of life.
The condition affects the pigmented layer of the retina the retinal pigment epithelium or rpe and the choroid. Serpiginous choroiditis is a rare recurrent eye disorder characterized by irregularly shaped serpiginous lesions involving two layers of the eye surface the retinal pigment epithelium and the choriocapillaris. Serpiginous choroiditis with branch vein occlusion and. This condition is usually bilateral and characterized by creamyyellow or white subretinal lesions at the level of the retinal pigment epithelium rpe and. To find a remedy for serpiginous choroiditis refractory to oral prednisone and chlorambucil treatment. Of these, 12 patients had an average of 45 months of drug free remission, and 14 maintained visual acuity within two snellen lines. Early treatment with cyclosporin in serpiginous choroidopathy. Geographic choroiditis, geographic helicoid peripapillary choroidopathy ghpc, geographic serpiginous choroiditis, peripapillary choriopathy, serpiginous choroidopathy. The clinical course, regardless of the presentation, is progressive with multiple recurrences. Systemic and infectious workup results, including an interferongamma release assay and herpesvirus titer, were negative. Diagnosis and management of serpiginous choroiditis. Serpiginous choroiditis sc is a recurrent inflammatory primary.
Serpiginous choroiditis sc is an asymmetrically bilateral inflammation of the choroid that leads to loss of choriocapillaris atrophy or loss of overlying retinal pigment epithelium. Results charts of twenty patients with serpiginous choroiditis 8 female, 12 male. Serpiginous choroiditis is a bilateral, inflammatory condition of the inner choroid and overlying retinal pigment epithelium with a distinctive retinal distribution. Apr, 2017 the macula was involved in the left eye but spared in the right. On the basis of the patients history, recurrencies, and clinical and fluorescein angiographic features, it was suspected that the disorder was of inflammatory origin, probably vasculitis due. The patient developed serpiginous choroiditis and had a reactive mantoux test 18 mm and igg titers of 1. Serpiginous choroiditis is a rare but important sightthreatening condition that has been previously associated to viral infections, which seem to have a role in the induction andor perpetuation of choroidal inflammation. The patient received antituberculosis treatment and corticosteroids. Nine patients with active, visionthreatening serpiginous choroiditis who had progressive inflammation while on steroids andor immunosuppressive agents other than alkylating agents treated at three tertiary care uveitis referral centers. Serpiginous choroiditis is a recurrent, bilateral, multifocal inflammatory disease. Ampiginous choroiditis following quadrivalent human papilloma. Symptoms include blurred vision and central and paracentral scotomas. Serpiginous choroiditis is a rare, usually bilateral, chronic, progressive, recurrent. Request pdf on oct 1, 2008, miguel corderocoma and others published serpiginous choroiditis find, read and cite all the research you need on researchgate.
Some disease entities have such a characteristic and striking appearance that their written descriptions are unmistakable. Fungal infection in patients with serpiginous choroiditis or. Serpiginous choroiditis is a rare, chronic, progressive, recurring inflammatory condition of unknown origin that primarily involves the choroid and the rpe. Serpiginous choroiditis ophthalmology jama network. Branch vein occlusion, retinal phlebitis, optic disc drusen, and elevated toxoplasmosis titers were unusual associated findings in the case described below. Three out of four patients achieved drugfree remission. After 3 months, the patient developed choroiditis in the other eye and was then treated with moxifloxacin hydrochloride for 1 month. Celiac disease and geographic serpiginous choroidopathy. Serpiginous choroiditis is a rare, usually bilateral, chronic, progressive, recurrent inflammation of the choroid, retinal pigment epithelium, and choriocapillaris of unknown etiology. Serpiginous choroiditis shows outer retinal atrophy in the affected areas, with disruption of the elm and the ez and increased reflectance of the choroid and deeper retinal layers. Infectious nontuberculous serpiginous choroiditis jama network. Pdf indocyanine greenmediated photothrombosis combined. Long term outcomes and management of patients with.
For language access assistance, contact the ncats public information officer. Sweptsource oct angiography of serpiginous choroiditis. A ssocta prototype was used to image active and quiescent serpiginous lesions longitudinally before and after antiinflammatory treatment. Visual acuity, clinical disease activity, duration of treatment, duration of drug free disease remission, and side effects of alkylating agent. Serpiginous choroiditis is a posterior uveitis displaying a geographic pattern of. Serpiginous choroiditis also called geographic helicoid peripapillary choroidopathy, is a rare idiopathic inflammatory eye disease affecting the inner choroid and retinal pigment epithelium that typically develops between age 30 and 70 years, although it may occur in younger patients 1. Pdf on jan 1, 2002, alejandro rodriguezgarcia published serpiginous. Serpiginous choroiditis secondary to bartonella henselae. Redfree fundus photography demonstrating typical aspect of peripapillary scarring with. This chronic, recurrent, progressive disease has a poor visual prognosis if the fovea is involved. Sep 16, 20 serpiginous choroiditis is a rare inflammatory eye condition that typically develops between age 30 and 70 years.
There were 7 women and 8 men with ages ranging from 20 to 65 years mean 35 years. An unusual presentation of ocular sarcoidosis find, read and cite all the research you need on researchgate. Serpiginous choroiditis like picture due to ocular toxoplasmosis. One such disease is serpiginous choroiditis, an idiopathic choroiditis that was given its name in 1970 by gass, 1 who had described the disease earlier in 1967. Dec 22, 2018 serpiginous choroiditis sc is defined as a rare type of posterior uveitis or choroiditis. Subretinal and disc neovascularisation in serpiginous. Serpiginous choroiditis ophthalmology jama ophthalmology. This disease is chronic and usually affects both eyes, leading to vision loss 24, 38. Typically serpiginous choroiditis occurs bilaterally and is relentlessly progressive.
The cause of sc remains unknown, although the possibility that it is an autoimmune disorder has been. Her clinical findings, along with a negative serology result, led to her receiving a diagnosis of serpiginous choroiditis. The new york institute for special educationnyise is a private, 501c3 nonprofit, nonsectarian educational facility which provides quality programs for children who are blind or visually disabled, emotionally and learning disabled and preschoolers who are developmentally delayed. Serpiginous choroiditis an overview sciencedirect topics. However, it has been reported in various studies that the incidence of serpiginous choroiditis is higher in india table 2. Serpiginous choroiditis, with both active and inactive lesions. Unilateral macular serpiginouslike choroiditis as the. Serpiginous choroiditis is a rare cause of posterior uveitis, usually less than 5% in most of the studies from the world. Vascular occlusion in serpiginous choroidopathy british. Serpiginous choroiditis sc is an asymmetrically bilateral.
Feb 01, 2020 placoid pigment epitheliopathy ppe and serpiginous choroiditis sc are inflammatory diseases affecting the retina and choroid. Serpiginous choroiditis sc is a rare, bilateral, idiopathic inflammatory disorder that. Immunological studies on 15 patients with serpiginous choroiditis gave no definite indications of the aetiology of the choroidal vascular lesion which appears to be the initial failure in this disorder. Pdf enigma of serpiginous choroiditis researchgate. While they raise the same questions regarding their pathogenesis, their natural history and prognosis differ, thus the importance of differentiating between the two so as to provide the most appropriate management. Forme fruste focal choroidal excavation in a case of serpiginous. Serpiginous choroiditis is an inflammatory condition of the choroid that affects the outer retina and the rpe. Serpiginous, first known to be used in the 15th century, is a term from latin serpere to creep, usually referring to a creeping, snakelike or slowly progressive skin disease it is used used to describe the rash in cutaneous larvae migrans, erythema annulare centrifugum, purpura annularis telangiectoides, ringworm.
The school was founded in 1831 as the new york institution for the blind as one of the first schools in the. It is characterized by helicoid destruction of both the choroid and rpe. An association between lesions resembling classic sc and tuberculosis was recognized as a possibly distinct clinical entity and named as tuberculous serpiginous like choroiditis. Serpiginouslike choroiditis as a marker for tuberculosis. Triple agent immunosuppression in serpiginous choroiditis. Aims to describe management and clinical outcomes of serpiginous choroidopathy treated primarily with cyclosporin at a tertiary uveitis referral centre methods a case series of 14 eyes of seven patients with serpiginous choroidopathy with follow up ranging from 1. Serpiginous choroiditis sc is a progressive and usually recurrent in. Successful treatment of serpiginous choroiditis with. Based on clinical presentation, it can be classified into 1 peripapillary, 2 macular, and 3 ampiginous types. Mfc shows irregularities at the level of the rpe or deeper in the choroid, sometimes with the presence of subretinal hyperreflective material and older lesions that. It is a chronic, recurrent, and progressive disease that typically affects patients 30 to 60 years of age. Seven of 14 patients showed evidence of exposure to. Serpiginous choroiditis sc is an asymmetrically bilateral inflammation of the. Most recent papers with the keyword serpiginous choroiditis.
Enigma of serpiginous choroiditis dutta majumder p, biswas j. Eight eyes of four patients all female with advanced macular involvement secondary to serpiginous choroiditis were included in the study. Serpiginous choroiditis sc is a progressive and usually recurrent inflammatory disorder of the choroid, retinal blood vessels, and pigment epithelium. Presentation of a case report of a unilateral ampiginous choroiditis. Serpiginous choroiditis rare diseases and genetic disorders. Optical coherence tomography angiography octa findings in. Serpiginous choroiditis september 2020 illinois retina. Serpiginouslike choroiditis as a marker for tuberculosis in.
Indocyanine greenmediated photothrombosis combined with. Chlorambucil combination therapy in refractory serpiginous. Fifteen patients suffering from serpiginous choroiditis were followed up for 1 to 10 years mean 4. All patients had fundus lesions consistent with serpiginous choroidopathy, were investigated for. Sarscov2 infection appears to have played a role as a possible trigger for intraocular inflammation in this case. Serpiginous choroiditis is a rare, usually bilateral, chronic, progressive, recurrent inflammation of the choroid, retinal pigment epithelium, and choriocapillaris of. Serpiginous choroiditis sc is a rare, chronic, asymmetrically bilateral posterior uveitis with a recurrent course. Affected individuals have lesions in the eye that last from weeks to months and involve scarring of the eye tissue. Ocular immunology and uveitis foundation genetic and rare. Fungal infection in patients with serpiginous choroiditis. In this condition the posterior uveitis shows a geographic pattern. Eye conditions blindness resource center the new york. There was unilateral decrease in central vision, scotoma, and retinal pigment epithelial atrophy. We report another case of celiac disease and atp associated with geographic serpiginous choroidopathy.
324 756 491 862 807 1504 369 218 1446 956 1034 862 238 1210 1035 891 1722 670 711 1153 522 1532 460 88 515 158