A Study of Serpiginous Choroiditis and the Utility of Aqueous Humour Analysis in Comparison with Conventional Investigations in the Recognition of Choroiditis due to Tubercular Aetiology

Abstract

An elusive aetiology of serpiginous choroiditis makes the diagnosis and management of this condition a challenge It causes painless progressive loss of vision acute vision threatening choroiditis needs timely institution of appropriate treatment to salvage vision Serpiginous choroiditis in the Indian population differs from other studies in the Caucasian population which report a later onset of the disease and unilateral presentation Preponderance of the disease in the younger age groups of life has been noted in the Indian population Bilateral involvement of eyes is more common in our patients with many having macular involvement at initial presentation necessitating early diagnosis and institution of therapy The visual loss itself is a consequence of complications such as active choroiditis involving the macula during the acute phase and choroidal neovascular membranes or scarring at the macula in the healed stages Although considered idiopathic the resemblance of the lesions to tubercular multifocal choroiditis needs to be explored and the possibility of mycobacterium tuberculosis MTB as the underlying cause has to be investigated The purpose of this study is to detect underlying tuberculosis if it does exist and to supplement treatment with antitubercular treatment ATT to hasten resolution of the disease and prevent the ocular morbidity associated with it newline