J Korean Ophthalmol Soc > Volume 58(1); 2017 > Article
Journal of the Korean Ophthalmological Society 2017;58(1):50-55.
DOI: https://doi.org/10.3341/jkos.2017.58.1.50    Published online January 15, 2017.
The Clinical Manifestations and Differential Diagnosis of Tuberculosis Serpiginous-like Choroiditis and Serpiginous Choroiditis.
Sung Hyun Ahn, Nam Chun Cho, Min Ahn, In Cheon You, Jin Gu Jeong
1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea. terathan@naver.com
2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea.
결핵 유사뱀모양맥락막염과 뱀모양맥락막염의 임상적인 감별
안성현1⋅조남천1,2,3⋅안 민1,2,3⋅유인천1,2,3⋅정진구1,2,3
전북대학교 의학전문대학원 안과학교실1, 전북대학교 임상의학연구소2, 전북대학교병원 의생명연구원3
Abstract
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.
Key Words: Serpiginous choroiditis;Tuberculosis serpiginous-like choroiditis


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