Prospective evaluation of intravitreal triamcinolone acetonide in serpiginous choroiditis

To evaluate intravitreal triamcinolone acetonide (IVTA) in unilateral serpiginous choroiditis with macular involvement with special reference to effectiveness of treatment and its side effects.

In this prospective nonrandomized, consecutive, interventional case series, IVTA was given in 8 eyes of 8 patients of unilateral active serpiginous choroiditis. Treatment was evaluated on both subjective and objective parameters: any improvement or stabilization of visual acuity, fundus and fluorescein angiography (FA) and central macular thickness on optical coherence tomography (OCT).

The treatment induced rapid remission clinically and vision improved or stabilized. Mean visual acuity improved from 0.93 +/- 0.21 LogMAR units at baseline to 0.36 +/- 0.24 (p = 0.00) LogMAR units at 6 months. A 33.73% reduction in mean central macular thickness was observed at the 6-month follow-up from 294.63 +/- 17.84 to 195.25 +/- 5.49 mum (p = 0.00). Lesions healed rapidly with FA and OCT proving the clinical observation.

Intravitreal triamcinolone may prove to be a promising therapeutic approach as a rescue therapy in this recurrent sight-threatening disorder by inducing rapid remission without the systemic side effects seen with systemic immunosuppression.