| Presentation preference | Oral presentation |
| Title | ‘Juxtapapillary’ Serpiginous-Like Choroiditis (SLC): A distinct phenotype of ocular TB predisposing to Anterior Scleritis (AS)! |
| Purpose | SLC and AS are two independent signs of ocular inflammation, bearing more differences than similarities, the former having a predominantly tubercular etiology, and the later an autoimmune background. We observed their sequential occurrence within the same eye of patients treated for ocular TB, and report their phenotypic features. |
| Methods | Retrospective review of 7 patients (11 eyes) who received ATT for SLC in a tertiary eye centre in North India. |
| Results | Mean age was 33.86 ± 14.02 years (4 males, 3 females). SLC was bilateral in 4 and unilateral in 3 patients (11 eyes). AS was bilateral in 2 and unilateral in 5 patients (9 eyes). AS developed ‘after’ SLC healed in 6 patients (range 5 months-17 years), and ‘with’ SLC in 1 patient. SLC lesions were placoid in 9 eyes (6 patients) and multifocal in 2 eyes (1 patient). SLC lesions were juxtapapillary in 9 eyes, involving macula in all. 2 eyes had paradoxical worsening of SLC, and one eye recurrence of SLC. AS was recurrent in 2 patients. |
| Conclusion | Juxtapapillary SLC with placoid macular lesions may represent a distinct phenotype of ocular TB, with an increased predisposition to AS. It strengthens the theory of MTB sequestration within the eye, rather than an immune-mediated hypersensitivity reaction. Considering the contiguous involvement of optic disc, retinochoroid and sclera in sequential pattern, it is possible that the hematogenous spread of MTB preferentially targets the optic nerve before the RPE-choroid complex, after which it invades the sclera. Whether the dormant MTB remains harbored within the RPE or sclera in between the episodes of choroiditis and scleritis needs to be explored. |
| Conflict of interest | No |
Authors 1
| Last name | BANSAL |
| Initials of first name(s) | R |
| Department | Advanced Eye Centre, PGIMER |
| City | Chandigarh |
| Country | India |
Authors 2
| Last name | Gupta |
| Initials of first name(s) | V |
| Department | Advanced Eye Centre, PGIMER |
| City | Chandigarh |
| Country | India |
Authors 3
| Last name | Gupta |
| Initials of first name(s) | A |
| Department | Advanced Eye Centre, PGIMER |
| City | Chandigarh |
| Country | India |
