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Tuberculosis-related choriocapillaritis (multifocal–serpiginous choroiditis): follow-up and precise monitoring of therapy by indocyanine green angiography

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Abstract

To report the case of a patient initially diagnosed with acute posterior multifocal placoid pigment epitheliopathy (APMPPE), characterized by relentless evolution despite high-dose steroid therapy. An interferon-gamma release assay (IGRA) indicated a diagnosis of suspected tuberculous choriocapillaritis and the disease responded only to massive inflammation suppressive therapy and antibiotic therapy. Case report. Review of clinical features and investigational procedures. Smoldering relentless evolution and subsequent arrest of progression could be precisely monitored by indocyanine green angiography (ICGA). The patient did not recover after standard anti-tubercolosis (TB) therapy combined with corticosteroid. A fourth antibiotic had to be added in order to stop the progression of the retinal disease. In each case of choriocapillaritis such as APMPPE an infectious cause including TB has to be excluded making IGRA tests unavoidable. As the main structure involved is the choriocapillaris the most precise follow-up or monitoring is obtained with ICGA.

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Authors and Affiliations

  1. Centre for Specialized Ophthalmic Care (COS), 6, rue de la Grotte, 1003, Lausanne, Switzerland

    Giulia De Luigi, Marina Papadia & Carl P. Herbort

  2. Dipartimento di discipline medico-chirurgiche della comunicazione e del comportamento, Università degli studi di Ferrara, Sezione di clinica oculistica, Ferrara, Italy

    Giulia De Luigi

  3. Department of Ophthalmology, Ospedale Valduce, Como, Italy

    Alessandro Mantovani

  4. Eye Clinic, Department of Neurosciences, Ophthalmology and Genetics, University of Genova, Genoa, Italy

    Marina Papadia

  5. University of Lausanne, Lausanne, Switzerland

    Carl P. Herbort

Authors
  1. Giulia De Luigi
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  2. Alessandro Mantovani
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  3. Marina Papadia
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  4. Carl P. Herbort
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Corresponding authors

Correspondence to Marina Papadia or Carl P. Herbort.

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De Luigi, G., Mantovani, A., Papadia, M. et al. Tuberculosis-related choriocapillaritis (multifocal–serpiginous choroiditis): follow-up and precise monitoring of therapy by indocyanine green angiography. Int Ophthalmol 32, 55–60 (2012). https://doi.org/10.1007/s10792-011-9508-y

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  • DOI: https://doi.org/10.1007/s10792-011-9508-y

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