Serpiginous Choroiditis (SC) Name Clinical Course, Recurrent Characteristics, Diagnostic Imaging Findings, CNV Differential Diagnosis and Treatment

 

👁 “Serpiginous Choroiditis – When Inflammation Slithers Across the Retina”

Serpiginous choroiditis (SC) is a rare, chronic posterior uveitis characterized by recurrent serpentine chorioretinal lesions
that begin around the optic disc and extend in a snake-like fashion toward the periphery.
The disease often spares the optic nerve, but macular involvement or CNV may significantly impact vision.

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✅ Key Clinical Summary of SC

FeatureDescription

Typical Patients	Adults aged 30–50, no gender predilection
Laterality	Bilateral but asymmetric onset
Disease Pattern	Recurrent serpiginous expansion from optic disc
→ “snake-like” lesion tracks
Stages
– Active phase: gray RPE swelling
– Inactive phase: geographic atrophy, RPE/choriocapillaris loss
Complications	Choroidal neovascularization (CNV) in 10–25%
± Cystoid macular edema (CME)
Imaging Features
FAG: Early hypofluorescence → late hyperfluorescence (border staining)
ICG: Persistent hypofluorescence
OCT: RPE/outer retina thinning, edema, CNV possible
Treatment
– Steroids for inflammation
– Immunosuppressants if frequent relapses
– Anti-VEGF injections for CNV
Prognosis	Good if CNV avoided; poor if macula involved or untreated relapses occur