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Serpiginous Choroiditis - Acute and Old 63-year-old woman has serpiginous choroiditis (date - March 2011). She has only had disease in the left eye. She had a steroid implant with your group in August of 2006. I injected the eye with Kenalog in January of 2007 and then she had another Kenalog injection in June of 2007. The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. She is on Cosopt and Combigan in the left eye because of her steroid responsive glaucoma. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50. IOP: OD 13, OS 11. The right eye has 2+ nuclear sclerosis. There are 2+ anterior vitreous cells. The left eye has a posterior chamber intraocular lens in good position. The eye is quiet. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There are 2+ vitreous cells. There is a new area of chorioretinitis inferonasal to the optic nerve, which is white and extends about 2-3 disc diameters off the nerve. OS: Vertical C/D ratio is 0.8. There is extensive chorioretinal scarring but there is no active inflammation. IMPRESSION: 1. ACTIVE SERPIGINOUS CHOROIDITIS – RIGHT AND GOOD EYE 2. PREVIOUS MACULAR SCARRING FROM SERPIGINOUS CHOROIDITIS – LEFT EYE 3. STEROID RESPONSIVE GLAUCOMA 4. CATARACT – RIGHT EYE DISCUSSION: I explained to the patient the right eye has active chorioretinitis from the serpiginous choroiditis and I suggested intravitreal Kenalog in that eye which has worked for her before. I injected the eye with Kenalog (4 mg/0.05 ml) was administered to the eye today without complication. I asked her to return in a week so I can see how the eye is doing. I asked her to start the Combigan drops in the right eye twice a day in anticipation of steroid responsive glaucoma. For management, I recommended every three month intravitreal Kenalog injections in the right eye for the next year and then to back off to every six months for the foreseeable future. It probably would not hurt to add Kenalog to the left eye as well.
Serpiginous Choroiditis192 views (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS900 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS692 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS826 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS790 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (1 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS968 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS775 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS956 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS743 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS849 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS828 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS821 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS665 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS549 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS570 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS540 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS577 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS568 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS579 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS720 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (1 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS535 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS477 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS501 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS550 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (1 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS570 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS544 views63-year-old woman has serpiginous choroiditis (date - March 2011). The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50 (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD743 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment (1 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD560 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment (0 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD556 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD714 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD681 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment (0 votes)	Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD691 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment (0 votes)
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD625 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment (0 votes)
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63-year-old woman has serpiginous choroiditis (date - March 2011). She has only had disease in the left eye. She had a steroid implant with your group in August of 2006. I injected the eye with Kenalog in January of 2007 and then she had another Kenalog injection in June of 2007. The right eye has not been previously involved, and then she noticed new onset floaters in the right eye for the last two weeks. Her vision in the right eye is hazy because of that. She is on Cosopt and Combigan in the left eye because of her steroid responsive glaucoma. VISUAL ACUITY: Vision OD is 20/25, OS is 20/50. IOP: OD 13, OS 11. The right eye has 2+ nuclear sclerosis. There are 2+ anterior vitreous cells. The left eye has a posterior chamber intraocular lens in good position. The eye is quiet. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.3. There are 2+ vitreous cells. There is a new area of chorioretinitis inferonasal to the optic nerve, which is white and extends about 2-3 disc diameters off the nerve. OS: Vertical C/D ratio is 0.8. There is extensive chorioretinal scarring but there is no active inflammation. IMPRESSION: 1. ACTIVE SERPIGINOUS CHOROIDITIS – RIGHT AND GOOD EYE 2. PREVIOUS MACULAR SCARRING FROM SERPIGINOUS CHOROIDITIS – LEFT EYE 3. STEROID RESPONSIVE GLAUCOMA 4. CATARACT – RIGHT EYE DISCUSSION: I explained to the patient the right eye has active chorioretinitis from the serpiginous choroiditis and I suggested intravitreal Kenalog in that eye which has worked for her before. I injected the eye with Kenalog (4 mg/0.05 ml) was administered to the eye today without complication. I asked her to return in a week so I can see how the eye is doing. I asked her to start the Combigan drops in the right eye twice a day in anticipation of steroid responsive glaucoma. For management, I recommended every three month intravitreal Kenalog injections in the right eye for the next year and then to back off to every six months for the foreseeable future. It probably would not hurt to add Kenalog to the left eye as well.