Retrospective analysis of the natural history and management of serpiginous choroiditis in Australia and New Zealand. (23rd January 2014)

• Record Type: Journal Article
• Authors: Toniolo, Jason; Hall, Anthony J; Sims, Jo; Fraser‐Bell, Samantha; Khan, Jane; Younan, Christine; Kent‐Smith, Brian; Young, Stephanie; Paul, Eldho; Lim, Lyndell L
• Is Part Of: Clinical & experimental ophthalmology. Volume 42:Number 7(2014)
• Page Start: 656
• Page End: 664
• Publication Date: 2014-01-23
• Subjects: Ophthalmology -- Periodicals; 617.7
• DOI: 10.1111/ceo.12283
• Languages: English
• ISSNs: 1442-6404

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="ceo12283-sec-0001" sec-type="section"> <title>Background</title> <p>To examine the prevalence of serpiginous choroidopathy in a predominantly Caucasian community, to examine associations between serpiginous choroiditis and other systemic diseases, and to report on the effect of immunosuppression on the long‐term course of serpiginous choroiditis.</p> </sec> <sec id="ceo12283-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective cohort study with patients from tertiary care centres and private practices.</p> </sec> <sec id="ceo12283-sec-0003" sec-type="section"> <title>Participants</title> <p>18 patients, mean age 48 years at baseline. One patient was seen only once. Median follow‐up was 69 months (5.8 years, range 0.4–29.7 years).</p> </sec> <sec id="ceo12283-sec-0004" sec-type="section"> <title>Methods</title> <p>Patients were identified using the Australian and New Zealand Ophthalmic Surveillance Unit. A chart analysis was performed for all patients. Three treatment groups were identified: no treatment, prednisolone monotherapy, or combination of prednisolone and immunosuppression. Negative binomial regression was used to calculate incidence rate ratios for patient relapse.</p> </sec> <sec id="ceo12283-sec-0005" sec-type="section"> <title>Main Outcome Measures</title> <p>Patient demographics, clinical features, associated systemic diseases, treatments administered and dates of relapse.</p> </sec> <sec id="ceo12283-sec-0006" sec-type="section"> <title>Results</title> <p>The disease prevalence in Australia and New Zealand is 1 case per 1.5 million people. Five cases (28%) had a positive QuantiFERON. A total of 32 relapses were observed: 14 while receiving no treatment, 11 on prednisolone and 7 on combination therapy. Compared with the no treatment group, the incidence rate ratio for prednisolone monotherapy and combination therapy was 1.29 and 2.92, respectively (95% confidence interval 0.40–4.14 and 0.96–8.88).</p> </sec> <sec id="ceo12283-sec-0007" sec-type="section"> <title>Conclusion</title> <p>Although the confidence intervals indicate that the difference in incidence rate ratios are not significant, these results suggest that there is a group of patients who have a benign course without long‐term immunosuppression or corticosteroid treatment.</p> </sec> </abstract>