Document Detail


Clinical features of tuberculous serpiginouslike choroiditis in contrast to classic serpiginous choroiditis.
MedLine Citation:
PMID:  20625045     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: 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. METHODS: Retrospective comparative analysis of clinical features of 5 patients with recurrent Tb-SLC and 5 with SC. RESULTS: 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. CONCLUSION: 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.
Authors:
Daniel V Vasconcelos-Santos; P Kumar Rao; John B Davies; Elliott H Sohn; Narsing A Rao
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of ophthalmology     Volume:  128     ISSN:  1538-3601     ISO Abbreviation:  Arch. Ophthalmol.     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-13     Completed Date:  2010-07-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7706534     Medline TA:  Arch Ophthalmol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  853-8     Citation Subset:  AIM; IM    
Affiliation:
Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA 90033, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged, 80 and over
Antitubercular Agents / therapeutic use
Choroiditis / diagnosis*,  drug therapy
Emigration and Immigration
Female
Fluorescein Angiography
Glucocorticoids / therapeutic use
Humans
Immunosuppressive Agents / therapeutic use
Male
Retrospective Studies
Tuberculosis, Ocular / diagnosis*,  drug therapy
Grant Support
ID/Acronym/Agency:
EY03040/EY/NEI NIH HHS
Chemical
Reg. No./Substance:
0/Antitubercular Agents; 0/Glucocorticoids; 0/Immunosuppressive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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