A new OCT finding in tuberculous serpiginous-like choroidopathy

Area of Science:

• Ophthalmology
• Infectious Diseases
• Medical Imaging

Background:

• Serpiginous choroiditis (SC) and serpiginous-like choroiditis (SLC) are inflammatory conditions affecting the choroid.
• Distinguishing between infectious and non-infectious etiologies is crucial for appropriate management.

Observation:

• A 60-year-old female presented with decreased vision and was diagnosed with serpiginous choroidopathy.
• Laboratory tests indicated an infectious etiology, specifically tuberculosis (positive QuantiFERON Gold).
• Enhanced depth imaging optical coherence tomography (EDI-OCT) was performed on active lesions.

Findings:

• EDI-OCT revealed previously unreported choroidal findings in tuberculous SLC.
• These findings included choroidal infiltration, elevation of the retinal pigment epithelium (RPE)-Bruch's membrane complex, and focal increases in choroidal thickness.
• Tuberculous etiology was confirmed by positive QuantiFERON Gold and chest CT findings consistent with granulomatous disease.

Implications:

• EDI-OCT findings of choroidal infiltration and RPE elevation may help differentiate tuberculous SLC from non-infectious SC.
• This imaging technique offers valuable characterization of choroidal involvement in infectious uveitis.
• Early and accurate diagnosis can guide targeted treatment for ocular tuberculosis.