1. Aravind Eye Hospital, Madurai
Serpiginous choroiditis/Geographic helicoid peripapillary choroidopathy (GHPC)
Dr. Rathinam Sivakumar
HOD - Uveitis Services
Aravind Eye Hospital, Madurai
India

2. Ocular History
19 year old male, engineering student
presented with c/o sudden onset painless progressive defect of vision in OD since 5 days
no similar complains in the past

3. General History No h/o trauma
No h/o cough, fever, weight loss in recent past
No h/o urogenital ulcerations
No h/o bleeding discariasis
No h/o neurological symptoms
No h/o any systemic illness

4. General examination patient moderately built and fairly nourished
conscious, co-operative, oriented to time, place and person
afebrile
no joint swellings
no rashes, nodules, vesicles
no pallor, icterus, cyanosis or lymphadenopathy
BP-110/80 mm Hg
pulse -80 /min, regular, good volume, equal on both sides

5. General Examination CVS - Normal RS - Normal Abdomen – Normal
CNS – No focal neurological deficit
Visual Acuity (Snellen’s)
OD-6/60
OS-6/6

6. Ocular Examination Ocular Examination – OD OS Lids Normal Conjunctiva
Cornea
Clear
Anterior Chamber
Normal Depth
Iris
Normal Colour and Pattern
Pupil
Normal size and reacting to light
Lens
Ocular Movements
Full
Ocular Examination –

7. Fundus OD: Yellow arrow- healed lesions
Red arrow-active lesion over macula
OS:
healed chorioretinal scars

8. FFA FFA- Active stage “Block early, stain late” Distinctly insidious
Chronic
Recurrent
variable in size and shape,
variable stages of progression,
Serpiginous choroiditis

9. Investigations TLC - 9,600 cells/cumm DLC – N 58%/ L 30%/ E 12 %
RBC million cells/cumm
Hb – 13.4 gm%
ESR 4mm-30min, 10 mm in 1 hr
Fasting sugar - 73 mg %
Blood urea - 14 mg%
Serum creatinine mg%
Tuberculin skin test (5 ppd) - negative
TPHA – negative
HIV - negative

10. Diagnosis Serpiginious chorioretinitis
not associated to systemic disorders

11. Diagnosis based on Clinical picture FFA findings Investigations
Negative tuberculin skin test
Negative VDRL
Normal spiral CT chest

12. Treatment
Oral prednisolone 60mg OD
in tapering doses

13. Follow ups of the OS June 27, 2009 6/60 2 weks later 6/36
3 weeks later /24
no recurrences

14. Thank you Asymptomatic if macula is spared Symptoms GHPC
chronic recurrent
Often we see a previous scar
Early hypo and
leak late
Asymptomatic if
macula is spared
Central hypo
and leaking borders
Vision loss > 2 lines
GHPC
Symptoms
Onset
course
FFA Active stage
FFA Healed stage
prognosis
Thank you