Clinical features of pachyvessels associated with polypoidal choroidal vasculopathy in chronic central serous chorioretinopathy.

To investigate the association between clinical features of chronic central serous chorioretinopathy (CSC) and subsequent development of polypoidal choroidal vasculopathy (PCV). Characteristics and treatment response of PCV secondary to CSC were described. This retrospective observational study included 18 patients with chronic CSC (18 eyes) with subsequent PCV and 36 controls (36 eyes) with chronic CSC without PCV development during follow-up. Clinical features were compared between the two groups. A logistic regression model was used to evaluate the risk factor of PCV formation. Treatments for PCV included anti-vascular endothelial growth factor (VEGF) monotherapy, photodynamic therapy (PDT), or PDT and anti-VEGF combination treatment. Subretinal fluid on optical coherence tomography images were assessed after treatments. Significant between-group differences were observed in best-corrected visual acuity after disease resolution and presence of pachyvessels (P = .001 and P = .003, respectively). The presence of pachyvessels in chronic CSC was associated with subsequent PCV (odds ratio = 6.00; 95% CI, 1.74-20.68; P = .005). CSC recurrence and subfoveal choroidal thickness (SFCT) were not significantly associated with subsequent PCV development (P = .393 and P = .911, respectively). The mean age of PCV diagnosis was 51 years, and the mean time from CSC diagnosis to PCV confirmation was 77.8 months. The mean (range) SFCT of PCV was 327.7 (134-599) µm. Nine patients received anti-VEGF monotherapy and 5 had disease remission. Four patients received PDT and anti-VEGF combination treatment and all of the 4 had disease remission. In chronic CSC, pachyvessel characteristics are associated with subsequent PCV development. This result will assist clinicians to evaluate CSC in clinical practice and provide insights into the pathogenesis of PCV.

Serpiginoid choroiditis associated with presumed ocular tuberculosis.

The purpose of this study is to present a case with serpiginoid choroiditis with possible ocular tuberculosis. The intraocular inflammation and choroiditis were successfully controlled by systemic antituberculosis treatment. A 63-year-old female presented with progressive bilateral blurred vision for over a year. At presentation, her best-corrected visual acuity was 6/20 in her right eye and counting fingers at 10 cm in her left eye. A fundus examination showed diffuse patchy geographic retinal pigment epithelium (RPE) changes with some pigmentation in both eyes. Fluorescein angiography disclosed leakage from RPE lesions and discs as well as retinal vasculitis. Systemic survey results for rheumatic and infectious diseases were normal except for a positive QuantiFERON-TB Gold test result. Her uveitis improved and chorioretinal lesions stabilized from the 2nd month of antituberculosis treatment. The antituberculosis treatment was discontinued after a 12-month course. No recurrence of uveitis was noted during the following 2 months. Diagnosing ocular tuberculosis is challenging. The clinical presentation, interferon-gamma release assay test, and clinical response to antituberculosis therapy can support a presumed diagnosis of tubercular uveitis. This case highlights that serpiginoid choroiditis can be a clinical presentation of ocular tuberculosis. Clinicians should pay attention to this etiology when facing a serpiginous-like retinal appearance.