Long-term Immunosuppresive Treatment of Serpiginous Choroiditis

We studied the efficacy of immunosuppressive treatment for patients with Serpiginous Choroiditis. The clinical courses of six patients (12 eyes) with vision threatening, steroid dependent or steroid resistant serpiginous choroiditis treated with a combination of immunosuppressive agents including Azathioprine, Cyclosporin, or Cyclophosphamide were reviewed. All patients underwent treatment for at least 12 months.

RESULTS: The follow-up period ranged from 17 to 105 months (mean 57). All patients were able to taper oral steroids. All six patients have discontinued all immunosuppressive medication after a treatment period of 12 to 19 months. Ten eyes had improved visual acuities, and vision remained impaired in 2 eyes due to macular scar. Recurrence was noted in 2 patients when an attempt was made to decrease the dose of immunosuppresive medications prior to the one year target. Two patients experienced side effects which were reversed by decreasing the dose of medication.

CONCLUSION: Long-term immunosuppresive treatment appears to prolong remission and preserve vision in patients with serpiginous choroiditis.

Download PDF C. Stephen Foster, M.D.
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