Uveitis and Ocular Immunology, LV Prasad Eye Institute, Hyderabad, India.
Department of Uveitis & Ocular Inflammation, Vittala International Institute of Ophthalmology & Prabha Eye Clinic and Research Center, Bangalore, India.
Ocul Immunol Inflamm. 2024 Oct;32(8):1549-1555. doi: 10.1080/09273948.2023.2258399. Epub 2023 Sep 28.
Serpiginous-like choroiditis (SLC) denotes ocular tuberculosis (TB), in the presence of positive tuberculin skin test (TST) or interferon gamma release assay (IGRA).
Retrospective review of SLC patients from a TB-endemic country, with negative TST and IGRA tests, but responsive to anti-TB therapy.
Fifteen patients (13 bilateral) with active SLC were included. Eleven (73.3%) patients had received corticosteroids ± immunosuppressive therapy prior to presentation. Chest radiographic abnormalities were found in four (26.7%) patients. We treated all patients with a combination of anti-TB therapy (ATT) and corticosteroids. Paradoxical worsening was noted in nine (60%) patients, complete resolution of lesions in 12 (80%), persistent inflammation (post-ATT) in one, while two were yet to complete ATT. None had recurrence after complete resolution of lesions (median follow-up of 71 weeks [range 15-676 weeks]).
TB-SLC may present with negative TST and IGRA tests but may still have clinical appearance, and treatment response, like test-positive disease.
匐行性脉络膜炎（SLC）表示眼部结核（TB），存在阳性结核菌素皮肤试验（TST）或干扰素γ释放试验（IGRA）。
对来自结核病流行国家的 SLC 患者进行回顾性分析，这些患者 TST 和 IGRA 检测均为阴性，但对抗结核治疗有反应。
共纳入 15 例（13 例双侧）活动性 SLC 患者。在就诊前，有 11 例（73.3%）患者接受了皮质类固醇±免疫抑制治疗。4 例（26.7%）患者有胸部 X 线异常。我们对所有患者均采用抗结核治疗（ATT）联合皮质类固醇治疗。9 例（60%）患者出现矛盾性加重，12 例（80%）患者病灶完全消退，1 例（7%）患者仍有炎症（ATT 后），2 例尚未完成 ATT。所有患者病灶完全消退后均无复发（中位随访时间为 71 周[范围 15-676 周]）。
TB-SLC 可能出现 TST 和 IGRA 检测均为阴性，但仍可能具有临床表现和治疗反应，与检测阳性疾病相似。
