Immunosuppressive therapy in serpiginous choroiditis - case report and brief review of the literature

Background: At present there is no consensus regarding the efficacy of the immunosuppressive therapy in serpiginous choroiditis. Patient and Methods: We describe the case of a patient with a macular serpi ginous choroiditis. Despite corticosteroid therapy the choroiditis was prog ressive and threatened the central vision. Therefore a triple immunosuppres sive therapy with prednisone 1 mg/kg body weight/day (mg/kg/d), azathioprin e 1.5 mg/kg/d, and low-dose cyclosporine A 4.5 mg/kg/d was introduced. Results: Under this triple immunosuppressive therapy a prompt stabilisation of the chorioretinal process could be observed in fluorescein angiography. After five months of therapy the examination of the visual field shows an impressive recovery. No significant side effects have been noted. Conclusions: In the literature, until now only six patients with serpiginou s choroiditis treated with a triple agent immunosuppressive therapy have be en reported. In all cases this regimen seemed to have a positive influence on the disease. Our present observation corroborates the beneficial effect of a triple agent immunosuppressive therapy on the course of serpiginous ch oroiditis. However, the beneficial effect of such a therapeutic approach ne eds to be confirmed by further observations.