title: Continuous progression of tubercular serpiginous-like choroiditis after initiating antituberculosis treatment.
abstract: OBJECTIVE
  To describe the frequency, risk factors, management, and outcome of eyes with tubercular serpiginous-like choroiditis showing continued progression following initiation of antituberculosis treatment.
  
  
  METHODS
  Retrospective, comparative, interventional case series.
  
  
  METHODS
  
  
  
  METHODS
  Institutional.
  
  
  METHODS
  One hundred ten patients of serpiginous-like choroiditis with 1) complete records, 2) tuberculin skin test, 3) active lesions in at least 1 eye, and 4) minimum 18 months follow-up.
  
  
  METHODS
  Based on the positivity of tuberculin skin test, the patients were categorized in Group A (84 patients with positive tuberculin test) and Group B (26 patients with negative tuberculin test). Of the 84 patients in Group A, 19 received systemic corticosteroids while 65 also received 4-drug antituberculosis treatment in addition. All patients in Group B received corticosteroids. Patients with continued progression received an increased dose of corticosteroids with or without immunosuppressive agents.
  
  
  METHODS
  Development of continued progression.
  
  
  RESULTS
  There were 61 men and 23 women in Group A and 19 men and 7 women in Group B. Continued progression was observed in 12 patients (14.28%) in Group A and none in Group B (P = .04). Of the 12 patients in Group A showing progression, 11 (16.9%) were receiving antituberculosis treatment and corticosteroids. The lesions responded in all eyes, and final visual acuity of 20/40 or better could be achieved in 10 eyes (75%).
  
  
  CONCLUSIONS
  Continued progression of choroiditis lesions occurs in 14% of patients after initiating antituberculosis treatment in tubercular serpiginous-like choroiditis. Increased immunosuppression with continuation of antituberculosis treatment resulted in good outcome.
authors.affiliation: Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. eyepgi@sify.com
authors.forename: Vishali
authors.initials: V
authors.lastname: Gupta
authors.forename: Reema
authors.initials: R
authors.lastname: Bansal
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D002833:Choroiditis / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014374:Tuberculin Test; D014392:Tuberculosis, Ocular / Q000188:drug therapy / Q000382:microbiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D005938:Glucocorticoids