Distinctive clinical features of idiopathic versus infectious serpiginous choroidopathy

Serpiginous choroidopathy (SC) is an inflammatory disease of unknown etiology. Infectious diseases that mimic SC are termed serpiginous-like choroidopathy (SLC). The aim of this study is to determine the clinical features of infectious SLC in comparison to SC.

Multicenter case series. Variables analyzed were age, gender, laterality, visual acuity, intraocular inflammation, multifocal pattern, choroidal neovascularization, involvement of juxtapapillary area, and posterior pole. Statistical significance was assessed by Mann-Whitney U test and Fisher's exact test.

Twenty-four patients had SC and 5 patients had SLC. Mean ages were 50 and 46 years (SC and SLC, respectively). In the SC group, 54% of the patients were males, and in the SC group, 80% were males. The disease was bilateral in 87.5% in the SC group and in 80% in the SLC group. The juxtapapillary area was involved in 91% in SC eyes and 0% in the SLC group (p < .05).

In cases where the peripapillary area is disease-free, an infectious etiology has to be strongly suspected, as an immunomodulatory treatment could have severe consequences.