Macular serpiginous choroiditis versus macular serpiginous-like choroiditis: clinical features, outcomes and...

To compare the clinical characteristics, treatment outcomes, and prognostic factors of macular serpiginous choroiditis (SC) and macular serpiginous-like choroiditis (SLC).

This retrospective multicentre study included 30 eyes of 25 patients with macular SC or SLC. All patients underwent detailed ophthalmic evaluation, including OCT, fundus autofluorescence (FAF), and fluorescein angiography. Atrophic and hyperautofluorescent FAF areas were quantitatively assessed using ImageJ.

Of the 30 eyes, 16 had macular SC and 14 had macular SLC. Atrophic area increased significantly in both groups but was greater in SC (2.8 ± 1.9 to 22.6 ± 8.3 mm²) than in SLC (4.1 ± 3.6 to 16.4 ± 7.0 mm²) (P < 0.001). Macular neovascularisation occurred more frequently in SC (43.7%) than SLC (7.1%) (P = 0.024). Visual outcomes were poorer in SC, with 31.2% achieving final visual acuity ≤0.1 logMAR, compared to 71.4% in SLC (P = 0. 028). All SC cases required systemic immunosuppression, versus 50% in SLC (P = 0.002), though treatment duration was longer in SLC (P = 0.007).

Macular SC exhibits more aggressive progression and worse visual prognosis than SLC. However, SLC requires prolonged immunosuppression to manage chronic inflammation.