Serpiginous choroidopathy

Abstract

Objective: To describe a case of serpiginous choroidopathy.

Methods: This is a case report.

Results: A 61-year-old female with a 22-year history of gradual blurring of vision in the left eye sought consultation. Ten months prior, her left vision worsened, described as central scotoma that progressed inferiorly. Best-corrected vision was 20/20 (right) and counting fingers at 1 foot (left). Inferior hemifield scotoma was documented on Amsler grid testing of the left eye. Anteriorsegment findings were unremarkable. Retinal examination through a clear media revealed multiple contiguous hypopigmented patches radiating from the peripapillary area extending to the periphery in both eyes with extension to the superior fovea on the left. Fluorescein angiogram showed progressive faint hypofluorescence of the hypopigmented patches in both eyes with involvement of the superior fovea on the left. No active vessel leakage was noted. No treatment was given and regular Amsler monitoring was advised. Follow-up 3 and 6 months after revealed stable visual acuity and fluorescein angiogram (FA) findings.

Conclusions: This is a case of serpiginous choroidopathy with inactive pattern. There was unilateral decrease in central vision, scotoma, and retinal pigment epithelial atrophy in a serpentine pattern originating from the disc with macular involvement in one eye. FA aids in the diagnosis and monitoring of inflammatory activity as the presence of active leakage on the borders. Goals of management include monitoring, prevention of recurrences and progression, and rapid control of sequela with potential use of immunosuppressive therapy.