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Clinical features of tuberculous serpiginouslike choroiditis in contrast to classic serpiginous choroiditis
Journal article   Open access   Peer reviewed

Clinical features of tuberculous serpiginouslike choroiditis in contrast to classic serpiginous choroiditis

Daniel V Vasconcelos-Santos, P Kumar Rao, John B Davies, Elliott H Sohn and Narsing A Rao
Archives of ophthalmology (1960), Vol.128(7), pp.853-858
07/2010
DOI: 10.1001/archophthalmol.2010.116
PMID: 20625045
url
https://doi.org/10.1001/archophthalmol.2010.116View
Published (Version of record) Open Access

Abstract

To compare distinctive clinical features of presumed tuberculous serpiginouslike choroiditis (Tb-SLC) with classic serpiginous choroiditis (SC) in patients living in a region that is nonendemic for tuberculosis. Retrospective comparative analysis of clinical features of 5 patients with recurrent Tb-SLC and 5 with SC. All patients with recurrent Tb-SLC primarily emigrated from areas highly endemic for tuberculosis and had been unsuccessfully treated with steroids/immunosuppressive agents. Results of uveitis investigations were negative except for positive tuberculin skin test results. These patients received oral tuberculostatic drugs, without recurrences (follow-up, 6-91 months). The ocular involvement in Tb-SLC was mostly unilateral, with multiple irregular serpiginoid lesions involving the posterior pole and periphery but usually sparing the juxtapapillary area. All 5 cases had inflammatory cells in the vitreous. Patients with SC were from areas nonendemic for tuberculosis, had negative uveitis workup findings (including tuberculin skin test results), and were successfully managed with steroids/immunosuppressive agents (follow-up, 6-72 months) with no recurrence. Ocular involvement in SC was usually bilateral, rarely multifocal, and primarily involved the posterior pole, especially around the optic disc and extending contiguously to the macula. No patient with SC presented with vitritis. In areas nonendemic for tuberculosis, SC can be clinically differentiated from Tb-SLC. Patients with Tb-SLC come from highly endemic regions, show significant vitritis, and often present with multifocal lesions in the posterior pole and periphery. Cases of SC, in contrast, reveal minimal or no vitritis and frequently show bilateral involvement with larger solitary lesions extending primarily from the juxtapapillary area and sparing the periphery.
Glucocorticoids - therapeutic use Humans Immunosuppressive Agents - therapeutic use Male Choroiditis - drug therapy Choroiditis - diagnosis Tuberculosis, Ocular - drug therapy Tuberculosis, Ocular - diagnosis Aged, 80 and over Adult Female Retrospective Studies Antitubercular Agents - therapeutic use Emigration and Immigration Fluorescein Angiography

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