Abstract
Serpiginous choroiditis (SC) is a chronic, recurrent inflammation, primarily affecting the choroid and choriocapillaris, with secondary involvement of the retinal pigment epithelium (RPE) and retina [1, 2]. It is usually bilateral, begins typically as peripapillary lesions of choroiditis, and spreads in a geographic pattern with remitting and relapsing clinical course [3]. The ultimate involvement of the fovea causes poor visual outcome. The etiology is not known, although an autoimmune mechanism has been speculated to be the underlying cause [4, 5]. Because of the morphologic pattern, it was previously known as geographic choroidopathy [6], or helicoid peripapillary chorioretinal degeneration [7], and subsequently termed serpiginoid choroiditis by Gass in 1970 [8].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
AM A e-A. Serpiginous (geographical) choroiditis. Int Ophthalmol Clin. 1995;35:87–91.
Lim WK, Buggage RR, Nussenblatt RB. Serpiginous choroiditis. Surv Ophthalmol. 2005;50:231–44.
Weiss H, Annesley WH, Shields JA, et al. The clinical course of serpiginous choroidopathy. Am J Ophthalmol. 1979;87:133–42.
Laatikainen L, Erkkilä H. Serpiginous choroiditis. Br J Ophthalmol. 1974;58:777–83.
Erkkilä H, Laatikainen L, Jokinen E. Immunological studies on serpiginous choroiditis. Graefes Arch Clin Exp Ophthalmol. 1982;219:131–4.
Hamilton AM, Bird AC. Geographical choroidopathy. Br J Ophthalmol. 1974;58:784–97.
Babel J. Geographic and helicoid choroidopathies. Clinical and angiographic study; attempted classification. J Fr Ophtalmol. 1983;6:981–93.
Gass JDM. Stereoscopic atlas of macular diseases: a funduscopic and angiographic presentation. St Louis: CV Mosby, Co; 1970. p. 66.
Gupta V, Gupta A, Arora S, et al. Presumed tubercular serpiginouslike choroiditis: clinical presentations and management. Ophthalmology. 2003;110:1744–9.
Bansal R, Gupta A, Gupta V, Dogra MR, Sharma A, Bambery P. Tubercular serpiginouslike choroiditis presenting as multifocal serpiginoid choroiditis. Ophthalmology. 2012;119(11):2334–42.
Khanamiri HN, Rao NA. Serpiginous choroiditis and infectious multifocal serpiginoid choroiditis. Surv Ophthalmol. 2013;58:203–32.
Vasconcelos-Santos DV, Rao PK, Davies JB, et al. Clinical features of tuberculous serpiginouslike choroiditis in contrast to classic serpiginous choroiditis. Arch Ophthalmol. 2010;128(7):853–8.
Chang JH, Wakefield D. Uveitis: a global perspective. Ocul Immunol Inflamm. 2002;10:263–79.
Carr RE, Noble KG. Disorders of the fundus. 8. Geographic (serpiginous) choroidopathy. Ophthalmology. 1980;87:1065–8.
Biswas J, Narain S, Das D, Ganesh SK. Pattern of uveitis in a referral uveitis clinic in India. Int Ophthalmol. 1996;20:223–8.
Fujisawa C, Fujiwara H, Hasegawa E, et al. The cases of serpiginous choroiditis (author’s transl). Nippon Ganka Gakkai Zasshi. 1978;82:135–43.
Gupta V, Agarwal A, Gupta A, et al. Clinical characteristics of serpiginous choroidopathy in North India. Am J Ophthalmol. 2002;134:47–56.
Soheilian M, Heidari K, Yazdani S, et al. Patterns of uveitis in a tertiary eye care center in Iran. Ocul Immunol Inflamm. 2004;12:297–310.
Wakabayashi T, Morimura Y, Miyamoto Y, et al. Changing patterns of intraocular inflammatory disease in Japan. Ocul Immunol Inflamm. 2003;11:277–86.
Rathinam SR, Krishnadas R, Ramakrishnan R, et al. Population-based prevalence of uveitis in Southern India. Br J Ophthalmol. 2011;95:413–7.
Singh R, Gupta V, Gupta A. Pattern of uveitis in a referral eye clinic in North India. Indian J Ophthalmol. 2004;52:121–5.
Gan WL, Jones NP. Serpiginouslike choroiditis as a marker for tuberculosis in a non-endemic area. Br J Ophthalmol. 2013;97:644–7.
Abrez H, Biswas J, Sudarshan S. Clinical profile, treatment, and visual outcome of serpiginous choroiditis. Ocul Immunol Inflamm. 2007;15:325–35.
Christmas NJ, Oh KT, Oh DM, et al. Long-term follow up of patients with serpiginous choroiditis. Retina. 2002;22:550–6.
Edelsten C, Stanford MR, Graham ER. Serpiginous choroiditis: an unusual presentation of ocular sarcoidosis. Br J Ophthalmol. 1994;78:70–1.
Fiore PM, Friedman AH. Unusual chorioretinal degeneration associated with sarcoidosis. Am J Ophthalmol. 1988;106:490–1.
Fuentes-Paez G, Celis-Sanchez J, Torres J, et al. Serpiginous choroiditis in a patient with systemic lupus erythematosus. Lupus. 2005;14:928–9.
Ugarte M, Wearne IM. Serpiginous choroidopathy: an unusual association with Crohn’s disease. Clin Experiment Ophthalmol. 2002;30:437–9.
Mulder CJ, Pena AS, Jansen J, et al. Celiac disease and geographic (serpiginous) choroidopathy with occurrence of thrombocytopenic purpura. Arch Intern Med. 1983;143:842.
Pinto Ferreira F, Faria A, Ganhao F. Periarteritis nodosa with initial ocular involvement. J Fr Ophtalmol. 1995;18:788–93.
Rattray KM, Cole MD, Smith SR. Systemic non-Hodgkin’s lymphoma presenting as a serpiginous choroidopathy: report of a case and review of literature. Eye (Lond). 2000;14:706–10.
Tang J, Fillmore G, Nussenblatt RB. Antiphospholipid antibody syndrome mimicking serpiginous choroidopathy. Ocul Immunol Inflamm. 2009;17:278–81.
Erkkila H, Laatikainen L, Jokinen E. Immunological studies on serpiginous choroiditis. Graefes Arch Clin Exp Ophthalmol. 1982;219:131–4.
King DG, Grizzard WS, Sever RJ, et al. Serpiginous choroidopathy associated with elevated factor VIII-von Willebrand factor antigen. Retina. 1990;10:97–101.
Bansal R, Gupta A, Gupta V, et al. Role of anti-tubercular therapy in uveitis with latent/manifest tuberculosis. Am J Ophthalmol. 2008;146:772–9.
Gupta A, Bansal R, Gupta V, et al. Ocular signs predictive of tubercular uveitis. Am J Ophthalmol. 2010;149:562–70.
Mackensen F, Becker MD, Wiehler U, et al. QuantiFERON TB-gold—a New test strengthening long-suspected tuberculous involvement in serpiginous-like choroiditis. Am J Ophthalmol. 2008;146:761–6.
Gupta A, Bansal R, Gupta V, Sharma A. Fundus autofluorescence in serpiginous-like choroiditis. Retina. 2012;32:814–25.
Rao NA, Saraswathy S, Smith RE. Tuberculous uveitis: distribution of mycobacterium tuberculosis in the retinal pigment epithelium. Arch Ophthalmol. 2006;124:1777–9.
Gass JDM. Stereoscopic atlas of macular diseases: a funduscopic and angiographic presentation. St Louis: CV Mosby, Co; 1997. p. 158–65.
Gass JDM. Stereoscopic atlas of macular diseases: diagnosis and treatment, vol. 1. 3rd ed. St Louis: Mosby; 1987. p. 136–44.
Priya K, Madhavan HN, Reiser BJ, et al. Association of herpes-viruses in the aqueous humor of patients with serpiginous choroiditis: a polymerase chain reaction-based study. Ocul Immunol Inflamm. 2002;10:253–61.
Rodman J, Pizzimenti J. Serpiginous choroiditis in a herpes-positive patient. Optom Vis Sci. 2011;88:776–80.
Mahendradas P, Kamath G, Mahalakshmi B, et al. Serpiginous choroiditis-like picture due to ocular toxoplasmosis. Ocul Immunol Inflamm. 2007;15:127–30.
Thomas S, Wiselka M, Dhar J, Bibby K. Syphilis presenting as acute multifocal retinochoroiditis. J R Soc Med. 2006;99:371–2.
Tsimpida M, Low LC, Posner E, et al. Acute syphilitic posterior placoid chorioretinitis in late latent syphilis. Int J STD AIDS. 2009;20:207–8.
Pisa D, Ramos M, Garcia P, et al. Fungal infection in patients with serpiginous choroiditis or acute zonal occult outer retinopathy. J Clin Microbiol. 2008;41:130–5.
Portero A, Careno E, Real LA, Villaron S, Herreras JM. Infectious nontuberculous serpiginous choroiditis. Arch Ophthalmol. 2012;130:1207–8.
Bansal R, Kulkarni P, Gupta A, et al. High-resolution spectral domain optical coherence tomography and fundus autofluorescence correlation in tubercular serpiginouslike choroiditis. J Ophthal Inflamm Infect. 2011;1:157–63.
Nayak S, Basu S, Singh MK. Presumed tubercular retinal vasculitis with serpiginous-like choroiditis in the other Eye. Ocul Immunol Inflamm. 2011;19:361–2.
Znaor L, Medic A, Karaman K, Perkovic D. Serpiginous-like choroiditis as sign of intraocular tuberculosis. Med Sci Monit. 2011;17(7):CS88–90.
Masi RJ, O’Connor GR, Kimura SJ. Anterior uveitis in geographic or serpiginous choroiditis. Am J Ophthalmol. 1978;86:228–32.
Bansal R, Gupta A, Gupta V. Imaging in the diagnosis and management of serpiginous choroiditis. Int Ophthal Clin. 2012;52:229–36.
Schatz M, Maumenee AE, Patz A. Geographic helicoid peripapillary choroidopathy: clinical presentation and fluorescein angiographic findings. Trans Am Acad Ophthalmol Otolaryngol. 1974;78:747–61.
Wolfensberger TJ, Piguet B, Herbort CP. Indocyanine green angiographic features in tuberculous chorioretinitis. Am J Ophthalmol. 1999;127:350–3.
Giovannini A, Mariotti C, Ripa E, et al. Indocyanine green angiographic findings in serpiginous choroidopathy. Br J Ophthalmol. 1996;80:436–40.
Giovannini A, Ripa E, Scassellati-Sforzolini B, et al. Indocyanine green angiography in serpiginous choroidopathy. Eur J Ophthalmol. 1996;6:299–306.
Cardillo Piccolino F, Grosso A, Savini E. Fundus autofluorescence in serpiginous choroiditis. Graefes Arch Clin Exp Ophthalmol. 2009;247:179–85.
Punjabi OS, Rich R, Davis JL, et al. Imaging serpiginous choroidopathy with spectral domain optical coherence tomography. Ophthalmic Surg Lasers Imaging. 2008;39(4 Suppl):S95–8.
van Velthoven ME, Ongkosuwito JV, Verbraak FD, et al. Combined en-face optical coherence tomography and confocal ophthalmoscopy findings in active multifocal and serpiginous chorioretinitis. Am J Ophthalmol. 2006;141:972–5.
Sharma K, Gupta V, Bansal R, Sharma A, Sharma M, Gupta A. Novel multitargeted polymerase chain reaction for diagnosis of presumed tubercular uveitis. J Ophthalmic Inflamm Infect. 2013;3:25.
Wu JS, Lewis H, Fine SL, et al. Clinicopathologic findings in a patient with serpiginous choroiditis and treated choroidal neovascularization. Retina. 1989;9:292–301.
Chisholm IH, Gass JD, Hutton WL. The late stage of serpiginous (geographic) choroiditis. Am J Ophthalmol. 1976;82:343–51.
Jampol LM, Orth D, Daily MJ, et al. Subretinal neovascularization with geographic (serpiginous) choroiditis. Am J Ophthalmol. 1979;88:683–9.
Laatikainen L, Erkkila H. Subretinal and disc neovascularization in serpiginous choroiditis. Br J Ophthalmol. 1982;66:326–31.
Lee DK, Suhler EB, Augustin W, et al. Serpiginous choroidopathy presenting as choroidal neovascularization. Br J Ophthalmol. 2003;87:1184–5.
Steinmetz RL, Fitzke FW, Bird AC. Treatment of cystoid macular edema with acetazolamide in a patient with serpiginous choroidopathy. Retina. 1991;11:412–5.
Baglivo E, Boudjema S, Pieh C, et al. Vascular occlusion in serpiginous choroidopathy. Br J Ophthalmol. 2005;89:387–8.
Friberg TR. Serpiginous choroiditis with branch vein occlusion and bilateral periphlebitis. Case report. Arch Ophthalmol. 1988;106:585–6.
Markomichelakis NN, Halkiadakis I, Papaethymiou-Orchan S, et al. Intravenous pulse methylprednisolone therapy for acute treatment of serpiginous choroiditis. Ocul Immunol Inflamm. 2006;14:29–33.
Hoyng C, Tilanus M, Deutma A. Atypical central lesions in serpiginous choroiditis treated with oral prednisolone. Graefes Arch Clin Exp Ophthalmol. 1998;236:154–6.
Hooper PL, Kaplan HJ. Triple agent immunosuppression in serpiginous choroiditis. Ophthalmology. 1991;98:944–51. discussion 951-952.
Nussenblatt RB. In discussion of Hooper PL, Kaplan HJ. Triple agent immunosuppression in serpiginous choroiditis. Ophthalmology.1991;98:944–951, discussion 951–952
Jabs DA, Rosenbaum JT, Foster CS, et al. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol. 2000;130:492–513.
Akpek EK, Baltatzis S, Yang J, et al. Long-term immunosuppressive treatment of serpiginous choroiditis. Ocul Immunol Inflamm. 2001;9:147–67.
Adiguzel U, Sari A, Ozmen C, et al. Intravitreal triamcinolone acetonide treatment for serpiginous choroiditis. Ocul Immunol Inflamm. 2006;14:375–8.
Wadhwa N, Garg SP, Mehrotra A. Prospective evaluation of intravitreal triamcinolone acetonide in serpiginous choroiditis. Ophthalmologica. 2010;224:183–7.
Gupta V, Bansal R, Gupta A. Continuous Progression of Tubercular Serpiginous-like Choroiditis After Initiating Antituberculosis Treatment. Am J Ophthalmol. 2011;152:857–63.
Basu S, Das T. Pitfalls in the management of TB-associated uveitis. Eye. 2010;24(11):1681–4.
Gupta V, Gupta A, Rao NA. Intraocular tuberculosis- an update. Surv Ophthalmol. 2007;52(6):561–87.
Cheung CM, Chee SP. Jarisch–Herxheimer reaction: paradoxical worsening of tuberculosis chorioretinitis following initiation of antituberculous therapy. Eye. 2009;23(6):1472–3.
Arevalo JF, Adan A, Berrocal MH, et al. Intravitreal Bevacizumab for inflammatory choroidal neovascularization: results from the Pan-American Collaborative Retina Study Group at 24 months. Retina. 2011;31:347–63.
Rouvas A, Petrou P, Douvali M, et al. Intravitreal ranibizumab for the treatment of inflammatory choroidal neovascularization. Retina. 2011;31:871–9.
Mansour AM, Arevalo JF, Ziemssen F, et al. Long-term visual outcomes of intravitreal bevacizumab in inflammatory ocular neovascularization. Am J Ophthalmol. 2009;148:310.e2–6.e2.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer India
About this chapter
Cite this chapter
Bansal, R., Gupta, A., Sharma, A., Sharma, K., Gupta, V. (2016). Serpiginous Choroiditis. In: Biswas, J., Majumder, P. (eds) Uveitis: An Update. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2295-8_17
Download citation
DOI: https://doi.org/10.1007/978-81-322-2295-8_17
Publisher Name: Springer, New Delhi
Print ISBN: 978-81-322-2294-1
Online ISBN: 978-81-322-2295-8
eBook Packages: MedicineMedicine (R0)