Abstract

P 185

Unilateral macular serpiginous choroiditis with vitreous infiltration

Ramona Verena Neutzner, Melanie Jäger, Birgit Lorenz
Klinik und Poliklinik für Augenheilkunde, Standort Gießen, Universitätsklinikum Gießen und Marburg GmbH, Gießen

Background
Serpiginous choroiditis is a rare disease related to the white dot syndromes which normally starts bilaterally, asymmetrically and peripapillary with only small vitreous involvement. We saw a case with unusual symptoms and follow-up.
Methods
Case report: A 54 year-old woman had a progressive visual loss of 0.2 in her left eye and a enormous cellular infiltration of the vitreous. In the right eye no morphological abnormalities were seen. The blood tests showed normal results for the immunological or infectious parameters, such as lyme disease or toxoplasmosis. The C-reactive protein showed a slight increase.
In addition to a local steroid therapy a systemic steroid treatment was initiated, resulting in a remarkable improvement of the vitreous infiltration. A funduscopic examination of the left eye demonstrated a large geographic white chorioretinal lesion throughout the macula. Fluorescein angiography showed early hypofluorescence followed by late leakage. Abnormalities in the outer segment of the photoreceptor layer, retinal pigment epithelium layer and choroidal layer were seen by Spectralis OCT. Surprisingly these abnormalities definitely exceed the funduscopic seen lesion.
The patient was treated with an immunosuppressive therapy, thereafter the disease remained stable.
Conclusions
Due to the progressive nature of the disease and the recurrent exacerbations an early diagnosis is desirable in order to initiate the adequate therapy and thus achieve a better visual outcome.

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