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Serpiginous choroiditis and infectious multifocal serpiginoid choroiditis
Hossein Nazari Khanamiri1, Narsing A Rao
1Department of Ophthalmology, Doheny Eye Institute, Keck School of Medicine of the University of Southern California, Los Angeles, California 90033, USA.
Survey of Ophthalmology
|April 2, 2013
Summary
Serpiginous choroiditis (SC) is an autoimmune eye inflammation affecting both eyes. Distinguishing SC from multifocal serpiginoid choroiditis (MSC) is crucial for proper treatment and vision preservation.
Area of Science:
- Ophthalmology
- Immunology
Background:
- Serpiginous choroiditis (SC) is a bilateral posterior uveitis characterized by geographic choroiditis.
- Its pathogenesis is presumed autoimmune, supported by response to immunosuppression and lack of systemic associations.
- SC can be mimicked by infectious multifocal serpiginoid choroiditis (MSC), particularly in tuberculosis-endemic areas.
Purpose of the Study:
- To present the distinguishing features of SC and infectious MSC.
- To emphasize the importance of differentiating SC from MSC to guide appropriate treatment.
- To highlight advances in diagnostics and therapeutics for SC.
Main Methods:
- Review of clinical presentations and diagnostic findings of SC and MSC.
- Comparison of histopathologic and microbiological evidence.
- Discussion of current and novel treatment modalities.
Main Results:
- SC typically affects healthy middle-aged individuals bilaterally.
- MSC presents with similar fundus changes but is associated with active tuberculosis or mycobacterial DNA.
- Accurate differentiation prevents unnecessary antimicrobial treatment for SC.
Conclusions:
- Distinguishing between SC and infectious MSC is critical for effective patient management.
- Advanced diagnostic and imaging techniques aid in differentiation.
- Novel treatments offer improved outcomes and vision preservation for SC patients.
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