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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.
Serpiginouse Choroiditis (Chorioretinitis) - Acute Right Eye - Old Left Eye VA 20/25 OD , 20/50 OS680 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 OS517 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 OS619 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 OS595 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 OS710 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 OS589 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 OS674 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 OS547 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 OS664 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 OS622 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 OS590 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 OS499 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 OS378 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 OS388 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 OS381 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 OS416 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 OS421 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 OS391 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 OS503 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 OS373 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 OS338 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 OS352 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 OS386 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 OS394 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 OS396 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 OD549 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 OD407 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 OD401 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 OD521 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 OD519 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 OD507 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 OD453 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.