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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.

serpiginousOD03151102.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS276 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
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serpiginousOD03151105.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS185 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
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serpiginousOD03151101.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS275 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
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serpiginousOD03151104.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS254 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
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serpiginousOD03151103.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS318 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
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serpiginousOD03151106.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS207 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
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serpig_maba08.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS330 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
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serpig_maba09.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS253 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
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serpig_maba10.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS234 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
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serpig_maba11.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS264 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
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serpig_maba12.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS227 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
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serpig_maba13.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS171 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
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serpig_maba14.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS95 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
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serpig_maba15.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS122 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
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serpig_maba16.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS113 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
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serpig_maba17.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS124 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
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serpig_maba18.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS110 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
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serpig_maba20.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS128 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
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serpig_maba19.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS182 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
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serpig_maba21.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS96 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
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serpig_maba22.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS84 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
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serpig_maba23.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS89 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
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serpig_maba24.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS113 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
33333
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serpig_maba26.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS133 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
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS98 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
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serpiginousOD1wkpivk_03221101.jpg
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD233 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment33333
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD152 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment00000
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD130 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment00000
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD212 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment00000
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD195 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment00000
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD192 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment00000
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Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS - 1 Week After Intravitreal Kenalog OD194 views63-year-old woman has serpiginous choroiditis 1 week after intravitreal kenalog treatment00000
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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.