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Ultra-Wide Field Imaging in Paradoxical Worsening of Tubercular Multifocal Serpiginoid Choroiditis after the Initiation of Anti-Tubercular Therapy |
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| Authors: | Kanika Aggarwal Aniruddha Agarwal Ankit Deokar Ramandeep Singh Reema Bansal Aman Sharma |
| Institution: | 1. Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India;2. Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India |
| Abstract: | Purpose: To evaluate role of ultra-wide field (UWF) versus conventional imaging in the follow-up and paradoxical worsening (PW) of tubercular (TB) multifocal serpiginoid choroiditis (MSC). Methods: Prospective observational study of patients with TB MSC undergoing UWF imaging, autofluorescence and fluorescein angiography was performed. A circle simulating central 75° field representing conventional imaging was drawn on UWF images. The information yielded by the two modalities, progression of choroiditis lesions and PW was compared. Results: 44 eyes (29 patients, mean age: 30.7 ± 9 years; 23 males) were included. UWF imaging showed additional lesions in 39/44 eyes (88.6%). Overall, 16/44 eyes (36.4%) showed PW; 3/16 eyes (18.7%) showed only peripheral PW, while 10/16 eyes showed both central and peripheral PW. Management was altered in 11 patients (37.93%) based on UWF imaging. Conclusions: UWF is more useful than conventional imaging in identifying additional choroiditis lesions, PW and altering the course of therapy in TB MSC. |
| Keywords: | Intraocular tuberculosis multifocal serpiginoid choroiditis paradoxical worsening serpiginous choroiditis TB ultra-wide field imaging |