Long–Term Visual Outcome of Patients Presenting With Serpiginous Choroiditis

Abstract

Abstract: : Purpose: To report the long–term evolution, complications, and visual outcome of patients presenting with serpiginous choroiditis Methods: Retrospective analysis of patients diagnosed with active serpiginous choroiditis in two tertiary eye care centers. They were treated with corticosteroids and different immunosuppressive (IS) regimens. Complete ophthalmologic examinations and fluorescein Angiographies have been regularly performed. Results: 23 patients (46 eyes) were included in this retrospective study. The mean follow–up period was 15 years. F/M ratio was 2. First symptoms appeared at the mean age of 41.5 years (range 20–75). Most usual visual complain was a loss of vision (49%), followed by myodesopsia (20%) and scotoma (11%). Fundus biomicroscopy revealed the disease in 29% of the eyes. The fellow eye was involved after a mean period of 21 months, but bilateral lesions were initially seen in 12/23 (52%) patients. The mean period from the first attack up to the last recurrence was 11.8 years. The mean number of recurrences during evolution of the disease in one eye was 2,2. Neovascularization occurred in 11% of the eyes. Final visual acuity was superior or equal to 20/40 in 23/46 eyes (50%), inferior or equal to 20/200 in 18/46 eyes (39%) and superior or equal to 20/100 and inferior or equal to 20/50 in 5/46 eyes (11%). Conclusions: Serpiginous choroiditis is a rare but severe condition requiring long term aggressive immunosuppressive therapy to maintain visual function. The best therapeutic strategy needs to be standardized.

Keywords: choroid • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled • autoimmune disease