Título

CLINICAL ASPECTS OF SERPIGINOUS CHOROIDITIS

Introdução / Purpose

To report the clinical aspects of the serpiginous choroiditis.

Material e Método / Methods

A 40-year-old male patient complained of decreased visual acuity (VA) in the left eye three years ago with progressive worsening for 30 days. On examination the best-corrected visual acuity (BCVA) was 20/20 in the right eye (OD) and count fingers at 0,5 meter in the left eye (OS). Biomicroscopy of the anterior segment was normal. Indirect binocular ophthalmoscopy revealed an extensive white-yellow chorioretinal lesion, with imprecise borders in peripapillary region. There was pigmentary retinopathy with mobilization of retinal pigment epithelial cells in both eyes, with foveal involvement only in the left eye. On the diagnostic suspicion of the serpirginous choroiditis, complementary tests were requested.

Resultados / Results

Fluorescein angiography revealed hypofluorescent plaques with hyperfluorescent borders in a geographical pattern (figure 1). Spectral-domain optical coherence tomography (SD-OCT) showed an extensive atrophy of the retinal layers. Serological tests for TORCH, HIV, syphilis, tuberculosis and hepatitis were normal. After 60 days of clinical treatment with oral prednisone there was partial improvement of the BCVA to 20/400 (OS).

Discussão e Conclusões / Discussion

Serpiginous choroidopathy or geographic choroiditis is a rare inflammatory disease that affects from young to old patients with recurrent episodes, characteristically. Clinical diagnosis is based on the fundoscopic appearance of the retinal lesions. Because of its unknown etiology there is no specific treatment for this disease, but corticotherapy may be effective in acute exacerbations, as shown in this case. However, 50% to 70% of patients will develop visual loss in one or both eyes due to macular involvement or occurrence of choroidal neovascularization. The main differential diagnoses are: toxoplasmosis, histoplasmosis, tuberculosis and acute posterior multifocal pigment epitheliopathy.

Palavras Chave

Serpiginous Choroidopathy; Inflammatory Disease; Chorioretinal Lesion

Area

CLINICAL RETINA