PURPOSE: The purpose of this study is to make a distinction between tuberculous serpiginous-like choroiditis and serpiginous choroiditis, and compare their clinical manifestations. METHODS: We retrospectively reviewed thirty eight eyes of twenty-six patients who visited our institution and were diagnosed with serpiginous choroiditis from January 2005 to December 2014. The patients were divided into two groups, tuberculosis serpiginous- like choroiditis (Tb-SLC) and classic serpiginous choroiditis (classic SC), and were analyzed based on the treatment response, previous history of Bacillus Calmette–Guérin (BCG) vaccination, positive results of tuberculin skin test (TST), chest X-ray, anterior and fundus examination, and fluorescein angiography (FAG). RESULTS: Twenty seven eyes of eighteen patients were serpiginous choroiditis and eleven eyes of eight patients were tuberculosis serpiginous-like choroiditis. There were no significant differences in age, sex, or previous history of BCG vaccination between the two groups. The positive result of the tuberculin skin test and abnormality in the chest X-ray were shown to be significantly higher in the Tb-SLC group. Multi-focal lesions involving periphery observed in fundus examination and FAG were significantly higher in Tb-SLC. CONCLUSIONS: In tuberculosis endemic areas such as Korea, tuberculosis serpiginous-like choroiditis should be considered as a differential diagnosis when the patient is suspicious of serpiginous choroiditis. The understanding of various clinical manifestations of tuberculosis serpiginous-like choroiditis may derive accurate diagnosis and treatment, enhancing patient's prognosis.
Bacillus ; Choroid* ; Choroiditis* ; Diagnosis ; Diagnosis, Differential* ; Fluorescein Angiography ; Humans ; Korea ; Mycobacterium bovis ; Prognosis ; Retrospective Studies ; Skin Tests ; Thorax ; Tuberculin ; Tuberculosis* ; Vaccination

PURPOSE: Scanning laser ophthalmoscope (SLO) has improved Infrared (IR) imaging. Since greater penetration of IR light permitted better visualization of subretinal structures, we evaluated chorioretinal layer in various chorioretinal dieases with SLO. METHODS: Cases of central serous chorioretinopathy (CSC), drusen, age-related macular degeneration (AMD), Vogt-Koyanagi-Harada disease, MEWDS (multiple evanesant white dot syndrome) and inflammatory choroiditis, toxoplasmosis, Stargardt's disease, proliferative diabetic retinopathy (PDR) and submacular hemorrhage were included. We used SLO (101, Rodenstock, Germany) for IR image and compared argon laser image with monochromatic IR image (780 nm wave length). RESULTS: The demarcation and extent of serous retinal detachment and macular star were more distinct in IR image. Small drusen, subretinal deposit and RPE atropy which could not be seen in argon green laser image were visible and appeared brightly with high reflectance in IR image. The CNV membrane which was not seen in full extent in argon laser image were observed completely in IR image. In case of inflammatory choroiditis, patch-like hot spot with surrounding high reflectance was observed in IR image. The subretinal structures and new vessels were clearly visible in IR image despite overlying thick preretinal fibrous prolifertive membrane and vitreous hemorrhage. CONCLUSIONS: The IR image using SLO is a fast and non-invasive diagnostic tool. Compared to fluorescein angiography, IR image gave a improved image for subretinal structure and additional information. Therefore IR imaging is recommended along with clinical symptom, FAG, ICGA for the diagnosis and treatment.
Argon ; Central Serous Chorioretinopathy ; Choroid ; Choroiditis ; Diabetic Retinopathy ; Diagnosis ; Fluorescein Angiography ; Hemorrhage ; Macular Degeneration ; Membranes ; Ophthalmoscopes ; Retina ; Retinal Detachment ; Toxoplasmosis ; Uveomeningoencephalitic Syndrome ; Vitreous Hemorrhage

The aim of current study was to evaluate the incidence and characteristics of ocular sarcoidosis in a Korean population. We conducted a retrospective study of 104 consecutive patients with biopsy-proven sarcoidosis seen at Asan Medical Center in Seoul, Korea, from 1993 to 2007. Medical records, photographs, and fluorescein angiograms were reviewed. Of 104 patients, 22 (21%) had intraocular involvement with female predominance (86%, M:F=3:19). Of the 39 eyes with ocular involvement, 16 (41%) eyes had isolated anterior uveitis, 12 (31%) eyes had intermediate uveitis, 6 eyes (15%) had panuveitis with retinal vasculitis, and 5 (13%) eyes had panuveitis with punched multifocal choroiditis. Mean duration of ophthalmologic follow-up was 62 months. All ocular inflammation was well managed with topical steroid and/or systemic steroid with relatively good final visual outcomes. Ocular complications such as cataract (12 eyes, 30%), glaucoma (6 eyes, 15%), vitreous opacity (1 eye, 3%), cystoid macular edema (3 eyes, 7%), neovascularization (2 eye, 5%), and epiretinal membrane (4 eye, 10%) were related to ocular sarcoidosis. In Korea, where sarcoidosis is very rare, our study indicates relatively low ocular and predominantly non posterior segment involvement with relatively good visual prognosis.
Adult ; Age Factors ; Asian Continental Ancestry Group ; Choroiditis/diagnosis ; Eye Diseases/*diagnosis/epidemiology/therapy ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Vasculitis/diagnosis ; Retrospective Studies ; Sarcoidosis/*diagnosis/epidemiology/therapy ; Steroids/therapeutic use ; Uveitis, Anterior/diagnosis ; Uveitis, Intermediate/diagnosis

The aim of current study was to evaluate the incidence and characteristics of ocular sarcoidosis in a Korean population. We conducted a retrospective study of 104 consecutive patients with biopsy-proven sarcoidosis seen at Asan Medical Center in Seoul, Korea, from 1993 to 2007. Medical records, photographs, and fluorescein angiograms were reviewed. Of 104 patients, 22 (21%) had intraocular involvement with female predominance (86%, M:F=3:19). Of the 39 eyes with ocular involvement, 16 (41%) eyes had isolated anterior uveitis, 12 (31%) eyes had intermediate uveitis, 6 eyes (15%) had panuveitis with retinal vasculitis, and 5 (13%) eyes had panuveitis with punched multifocal choroiditis. Mean duration of ophthalmologic follow-up was 62 months. All ocular inflammation was well managed with topical steroid and/or systemic steroid with relatively good final visual outcomes. Ocular complications such as cataract (12 eyes, 30%), glaucoma (6 eyes, 15%), vitreous opacity (1 eye, 3%), cystoid macular edema (3 eyes, 7%), neovascularization (2 eye, 5%), and epiretinal membrane (4 eye, 10%) were related to ocular sarcoidosis. In Korea, where sarcoidosis is very rare, our study indicates relatively low ocular and predominantly non posterior segment involvement with relatively good visual prognosis.
Adult ; Age Factors ; Asian Continental Ancestry Group ; Choroiditis/diagnosis ; Eye Diseases/*diagnosis/epidemiology/therapy ; Female ; Fluorescein Angiography ; Humans ; Male ; Middle Aged ; Retinal Vasculitis/diagnosis ; Retrospective Studies ; Sarcoidosis/*diagnosis/epidemiology/therapy ; Steroids/therapeutic use ; Uveitis, Anterior/diagnosis ; Uveitis, Intermediate/diagnosis

I. Central Serous Chorioretinopathies: One hundred and nine patients with central serous retinopathy were an a lysed after treatment with AO Laser Photocoagulator. The patients in this study were mainly male (87%) between the ages of 30 and 40 years (81.5%). Involvement was exclusively unilateral (98.1 %), and fluorescein fundus angiography revealed leaking points in almost all cases (98.1%). Majority of patients (67.4%) recovered normal vision with one or two sittings of photocoagulation, each sitting composed of 6 to 8 energy pulses producing grade I lesion. During the course of this study normal vision is gained in 80.2% of patients. With the development of fluorescein fundus angiography the lesion of central serous retinopathy were found to be choroidal abnormalities associated serous leakage across Bruch's membrane. Burn is made by the light energy delivered to pigment epithlium. The burn results, through normal healing processes, in a scar, which seals off the communication across Bruch's membrane. This phenomenon constructs the basis of treatment of central serous retinopathy with photocoagulation. II. Diabetic Retinopathies: Diabetic retinopathy is rapidly becoming the prominent cause of blindness in the world. The striking change of retinopathy is in the venous side of retinal capillaries and their altered function leads to exudation, hemorrhage, formation of new vessels, and fibrosis over the retinal plane or into vitreous, resuJting ultimately into blindness. Of the 34 patients treated with AO Ruby Photocoagulator at Han Yang Uni. Hos., the response of the patients in pre-proliferative stage was excellent, all of them recovering vision above 0.8. The patients in proliferative stage, however, responded poorly to photocoagulation. It is learned in this study that the optimal time of photocoagulation is in the pre-proliferative stage. The photocoagulation of retinitis proliferans has some effect only in arresting or delaying the progress of retinal changes. III. Focal Choroiditis: Nonsuppurative intracular inflammation is caused by various etiology. Scrutinization such as serologic and skin test or x-ray finding is important for the diagnosis of uveitis but not so significant as the definitive clinical characteristics of specific forms of ocular inflammation. Focal choroiditis, sized less than 1/4 disk diameter, was coagulated with ruby laser. Four out of 6 patients recovered good vision, the lesion being replaced by a scar. The remaining two patients did not visit the hospital after one session of photocoagulation. It is emphasized by the author that the focal choroiditis is excellent indication to the laser photocoagulation. IV. Eales' Disease: Eales' disease is considered to be due to hypersensitivity to mostly tuberculo-antigen, clinically characterized by retinal perivenous exudate, neovascularization and vitreous hemorrhage. A boy has recovered his normal vision after 18 sessions of ruby laser photocoagulation. There have been no benificent effects where photocoagulation was discontinued after two or three sittings.
Angiography ; Blindness ; Bruch Membrane ; Burns ; Capillaries ; Central Serous Chorioretinopathy ; Choroid ; Choroiditis ; Cicatrix ; Diabetic Retinopathy ; Diagnosis ; Exudates and Transudates ; Fibrosis ; Fluorescein ; Hemorrhage ; Humans ; Hypersensitivity ; Inflammation ; Lasers, Solid-State* ; Light Coagulation* ; Male ; Retinal Diseases* ; Retinaldehyde* ; Retinitis ; Skin Tests ; Strikes, Employee ; Uveitis ; Vitreous Hemorrhage