Abstract
Purpose: :
To describe the evolution of fundus autofluorescence (FAF) and Spectral domain-Optical Coherence Tomography (SD-OCT) alterations of Serpiginous Choroiditis (SC) lesions throughout time since acute stage until resolution of inflammation.
Methods: :
This is a retrospective case series. Serial FAF and SD-OCT images from 7 patients with SC performed since lesions presented active inflammation until they became inactive were reviewed.
Results: :
Twenty two lesions of 7 patients were included. There were 5 woman and 2 men. Mean age was 59.6 years. Five cases were classified as classic SC , 1 case as Ampiginous choroiditis and 1 case as presumed tubercular serpiginouslike choroiditis. Mean follow-up was 14 months. The most complete sequence of changes in FAF from active inflammation of the lesion to absolute resolution of inflammatory activity were observed in 3 patients and consisted of: 1: Faint hypoautofluorescence surrounded by a thin halo of hyperautofluorescence . 2: hyperautofluorescence of the lesion with hypoautofluorescent spots surrounded by a thin hypoautofluorescent ring. 3: Progressive darkening of the lesion until complete hypoautofluorescence. In 4 of the patients FAF changes were only observed since hyperautofluorescence phase on. Funduscopy also showed a sequence of alterations since active stage until resolution. In symptomatic patients, funduscopy showed signs of inflammatory activity earlier than FAF. The most complete sequence of changes in SD-OCT from active inflammation of the lesion to absolute resolution of inflammatory activity were observed in 2 patients and consisted of: 1. Hyperreflective lesion in the external retina (which corresponded to the earliest inflammatory sign of activity in funduscopy). 2: Disruption of the third hyperreflective band and thickening of the retinal pigment epithelium (RPE) (which corresponded to hyperautofluorescence of the lesion with hypoautofluorescent spots surrounded by a thin hypoautofluorescent ring). 3: Disruption of third hyperreflective band and of the RPE (which corresponded to hypoautofluorescence of the lesion).
Conclusions: :
Evolutive morphological changes of lesions of SC since acute stage until chronic stage can be observed with both FAF and SD-OCT imaging. These diagnostic techniques may help to assess properly the inflammatory activity of the disease and hence determine the level of immunosuppression needed in every case.
Keywords: uveitis-clinical/animal model • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • imaging/image analysis: clinical