Serpiginous Choroidopathy -Multifocal - David Drucker - 2024 03 скачать в хорошем качестве

Serpiginous Choroidopathy -Multifocal - David Drucker - 2024 03

This case involves a 68-year-old female patient with a history of multiple sclerosis, systemic hypertension, and other comorbidities, who presents with blurred vision and dark spots in her right eye, as well as floaters in both eyes. Her vision has progressively worsened over several months, and she has also developed headaches. On examination, her visual acuity was 20/32 OU, with multifocal yellow-gray fundus lesions, mild vitreous cells in the right eye, and additional findings on OCT, FA, and ICGA, suggestive of multifocal choroiditis. Following workup for potential infectious or autoimmune causes, she was treated with high-dose steroids, transitioning to oral steroids and Methotrexate. The differential diagnosis includes various forms of posterior uveitis such as acute posterior multifocal placoid pigment epitheliopathy, serpiginous choroiditis, and autoimmune chorioretinopathies, with a special focus on infectious etiologies like tuberculosis and syphilis, which were ruled out. The patient’s imaging and clinical course were consistent with the multifocal variant of serpiginous choroiditis, an idiopathic inflammatory disorder with a poor visual prognosis, as 25% of treated cases end with a final visual acuity below 20/200. Continuous monitoring is essential due to the risk of recurrence and complications like choroidal neovascularization. Key teaching points from this case include the importance of a thorough diagnostic workup to rule out infectious causes, especially tuberculosis and syphilis, which have historically been associated with serpiginous choroiditis. Additionally, clinicians must be aware that aggressive systemic immunosuppressive treatment is necessary to prevent recurrences and long-term complications, though the prognosis remains guarded. Monitoring for new lesions and complications like CNV and CME is critical in long-term management. This video shows a discussion of a teaching case from the University of South Florida Department of Ophthalmology Retina Imaging Conference. This case is first presented and discussed as an unknown. The presenting ophthalmology resident knows the case and the discussing ophthalmology resident does not know the case. After reviewing the case and the findings from the history and imaging, a differential diagnosis is established. Subsequently a diagnosis is determined. The presenting ophthalmology resident then discusses that disease entity. This case is intended for educational purposes only. This video is not designed to and does not provide medical advice, professional diagnosis, opinion, treatment or services to you or to any other individual. This video is not a substitute for medical or professional care, and you should not use this information in place of a visit, call consultation or the advice of your physician or other healthcare provider. IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY, YOU SHOULD IMMEDIATELY CALL 911 OR YOUR PHYSICIAN. If you believe you have any other health problem, or if you have any questions regarding your health or a medical condition, you should promptly consult your physician or other healthcare provider. Never disregard medical or professional advice, or delay seeking it, because of something you see in this video. Never rely on information in this video in place of seeking professional medical advice. You should also ask your physician or other healthcare provider to assist you in interpreting any information in this video. Medical information changes constantly. Therefore, the information in this video should not be considered current, complete or exhaustive, nor should you rely on such information to recommend a course of treatment for you or any other individual. Reliance on any information provided in this video is solely at your own risk.