LAUSR

Clinicopathologic Features of Tuberculous Serpiginous-like Choroiditis Serpiginous-like choroiditis (SLC) is a choroidal inflammation of diverse causes, which clinically resembles serpiginous choroiditis.1 Intraocular tuberculosis commonly presents as SLC in countries where Mycobacterium tuberculosis is endemic. In this choroiditis, M tuberculosis is rarely demonstrated in ocular fluids by smear or culture.1,2 Although a biopsy of the affected tissue can yield a tuberculosis diagnosis, such an approach is discouraged because of potentially severe ocular complications. Thus, to our knowledge, histopathologic changes in SLC remain largely unknown. We report clinicopathologic features of SLC. Report of a Case | During his stay in the United States, a 28-yearold Indian man developed blurred vision in his left eye. His visual acuitywas20/16ODand20/100OS.Examinationresultswereunremarkable in the right eye, but examination of the left eye revealed a focal choroiditis. Fundus fluorescein angiography showed early hypofluorescence and late hyperfluorescence (Figure 1A), and optical coherence tomography revealed outer retinal and choroidal changes (Figure 1B). Diagnoses of macular serpiginouschoroiditisandacuteposteriormultifocalplacoidpigment epitheliopathy were entertained. The patient tested positive for M tuberculosis on the QuantiFERON-TB Gold test. He started receiving 4 drugs for anti–M tuberculosis treatment (ATT): isoniazid, rifampin, pyrazinamide, and ethambutol. At 3 weeks, his visual acuity decreased to hand motions OS, and the macularlesionexpanded,simulatingserpiginouschoroiditis(Figure1C).