Autofluorescence imaging for diagnosis and follow‐up of serpiginous choroiditis

• Published in: Acta ophthalmologica (Oxford, England) Vol. 100; no. S275
• Main Authors: Abellán, Maria Victoria Navarro, Perea, Juan Antonio Sánchez, Menargues, Manuel Almarcha, López, Carmen Miquel, Moreno, Elisa Foulquié, Molina, Celia Gómez, Garcia‐Medina, Jose Javier
• Format: Journal Article
• Language: English
• Published: Malden Wiley Subscription Services, Inc 01.12.2022
• Subjects: Acuity; Atrophy; Choroiditis; Differential diagnosis; Immunotherapy; Inflammatory diseases; Mantoux test; Patients; Retina; Steroids; Tuberculosis; Uveitis; Visual acuity
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2022.0509

Purpose: To report by multimodality imaging the follow‐up of a patient with posterior uveitis presenting serpiginous choroiditis (SC). To highlight the importance of autofluorescence in the follow‐up of patients with atrophic scarring due to CS. Methods: We present an observational case of SC documented photographically. Clinical data were gathered retrospectively from several visits. The data included corrected visual acuity (BCVA), fundus examination, optical coherence tomography (OCT) and autofluorescence (AF). Results: Periodic revision of a 49‐year‐old female being followed up for SC secondary to tuberculosis. Mantoux test was positive in 2010 and she was treated correctly. Twelve years later, BCVA was hand movements in the right eye and in the left eye 20/40. Fundus examination revealed no presence of vitritis and atrophic scars post choroiditis serpiginosa. OCT displayed disruption of outer retinal layers. AF revealed atrophy plaque with a new diffuse hypoautofluorescence halo surrounding hyperautofluorescent rim. Aqueous humour and vitreous sample results were negatives. Finally, the lesion was diagnosed as a serpiginous choroiditis. She was treated with corticosteroid and biological therapy to improve her visual acuity. It should suggest a reactivation of SC the appearance of a new atrophy plaque with ill‐defined creamy rim, early block and diffuse oozing at late times, choroidal hypoperfusion, diffuse hypoautofluorescence halo surrounding hyperautofluorescent rim and disruption of outer retinal layers with ellipsoid loss. Conclusions: A differential diagnosis should be made between SC and posterior uveitis secondary to tuberculosis. Multimodal imaging by autofluorescence is important for the diagnosis and follow‐up of patients with atrophic scarring due to SC. Differential diagnosis of cause posterior uveitis is essential for the monitoring and treatment. In inflammatory diseases always rule out infection prior to corticosteroid treatment or biological therapy.