Early treatment with cyclosporin in serpiginous choroidopathy maintains remission and good visual outcome

Abstract

AIMS—To describe management and clinical outcomes of serpiginous choroidopathy treated primarily with cyclosporin at a tertiary uveitis referral centre
METHODS—A case series of 14 eyes of seven patients with serpiginous choroidopathy with follow up ranging from 1.3 to 13 years is described. All patients had fundus lesions consistent with serpiginous choroidopathy, were investigated for systemic disease, had fluorescein angiography, and were treated with combined immunosuppressive therapy including cyclosporin.
RESULTS—No patients suffered significant loss of acuity after starting systemic immunosuppression with cyclosporin as the primary agent. All but one patient achieved remission and were able to stop medications with no recurrences in the follow up period. Side effects from cyclosporin were well tolerated and there were no serious complications from immunosuppression.
CONCLUSIONS—Cyclosporin is a safe and effective option with which to manage serpiginous choroidopathy. Significantly, adequate immunosuppression can result in clinical remission and cessation of therapy in some patients.



Full Text

The Full Text of this article is available as a PDF (143.2 KB).

Figure 1  .

Visual acuity at initial assessment versus final visual acuity for all patients. The single patient whose distance vision decreased because of mild cataract retained N5 reading vision.

Figure 2  .

Fluorescein angiogram (right eye, patient 4). Note the typical geographic areas of choroidal atrophy radiating from the disc and spreading towards the macula. There is a new, small area of disease activity approximately 1 disc diameter above the fovea visible on the red-free photograph (A), which in the angiogram is characterised by early hypofluorescence (B) and late hyperfluorescence (C).