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Tubercular serpiginous-like choroiditis presenting as multifocal serpiginoid choroiditis
Reema Bansal1, Amod Gupta, Vishali Gupta
1Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Ophthalmology
|August 16, 2012
Summary
Antitubercular therapy (ATT) effectively treated tubercular serpiginous-like choroiditis, reducing recurrences and improving visual acuity. This condition often affects young men, presenting as bilateral, multifocal lesions, but typically spares the fovea.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Tubercular serpiginous-like choroiditis is a rare inflammatory eye condition.
- Diagnosis requires ruling out other causes of uveitis and confirming tuberculosis infection.
Purpose of the Study:
- To detail the clinical presentation, disease course, and treatment outcomes of tubercular serpiginous-like choroiditis.
Main Methods:
- Retrospective cohort study of 105 patients (141 eyes) diagnosed with active tubercular serpiginous-like choroiditis.
- Inclusion criteria included positive tuberculosis testing, active choroiditis, and exclusion of other uveitis causes.
- Treatment involved antitubercular therapy (ATT) with or without corticosteroids, with a minimum 9-month follow-up.
Main Results:
- The condition predominantly affected young to middle-aged men, often bilaterally, with multifocal lesions involving the macula.
- ATT led to lesion resolution in all patients, with a 9.7% recurrence rate.
- Final visual acuity improved significantly, with 76.6% achieving ≥ 6/12, and the fovea was spared in 76% of macular cases.
Conclusions:
- Tubercular serpiginous-like choroiditis is characterized by multifocal, serpiginoid lesions, frequently bilateral, in young men.
- Antitubercular therapy is crucial for lesion resolution and reducing recurrence.
- Combined ATT and steroid therapy generally leads to good visual outcomes, often preserving foveal function.
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