Fundus Autofluorescence and Spectral Domain Optical Coherence Tomography in Recurrent Serpiginous Choroiditis: Case Report

Abstract

Autofluorescence imaging and SDOCT are useful noninvasive methods for the evaluation of serpiginous choroiditis. Autofluorescence imaging allows identification of recurrences and retinal pigment epithelium involvement in the follow-up of this disease.

OCT and Fundus Autofluorescence Enhances Visualization of White Dot Syndromes

“…Serpiginous choroiditis lesions are gray/white and are linear in appearance, commonly located within the macula and juxtapapillary region. 4,5,13 Active lesions may also be associated with subretinal fluid. During recovery of the acute lesions, atrophy of the choriocapillaris, RPE, and outer retinal layers is often observed.…”

“…5,13,50 This is followed by atrophy of the retinal layers, with the RPE, ISe line, and outer nuclear layer becoming indistinguishable. 4,5,13 Increased reflectance of the choroid occurs as the RPE becomes attenuated during healing. This matches with ICG angiography findings that show persistence of choroidal activity even when the signs of retinal activity had disappeared.…”

Optical coherence tomography imaging in uveitis

“…Eyes with neovascular membranes located anterior to and separated from the RPE that had an 'optically clear zone' underneath were the best candidates for surgical removal [153]. SD OCT technology has also been utilized to define retinal morphological changes in patients with serpiginous choroiditis [154,155]. In one study, FAF was evaluated along with SD OCT in a patient with recurrent serpiginous choroiditis.…”

“…Active new lesions disclosed hyperautofluorescence in contrast to hypoautofluorescence in scarred lesions. OCT showed increased reflectance of the choroid and deeper retinal layers, along with disruption of the photoreceptor IS/ OS junction in both active and inactive lesions [155]. Figure 11 shows a high-definition SD OCT scan of a patient with serpiginous-like choroiditis.…”

Optical coherence tomography and fundus autofluorescence imaging in uveitis

“…OCT of inactive serpiginous lesions demonstrates atrophy of the outer retina, including the outer nuclear layer, IS/OS junction and the RPE [55,56]. RPE atrophy is associated with increased penetration of the OCT into deeper layers of the choroid and sclera.…”