title: Retrospective analysis of the natural history and management of serpiginous choroiditis in Australia and New Zealand.
abstract: BACKGROUND
  To examine the prevalence of serpiginous choroidopathy in a predominantly Caucasian community, to examine associations between serpiginous choroiditis and other systemic diseases, and to report on the effect of immunosuppression on the long-term course of serpiginous choroiditis.
  
  
  METHODS
  Retrospective cohort study with patients from tertiary care centres and private practices.
  
  
  METHODS
  18 patients, mean age 48 years at baseline. One patient was seen only once. Median follow-up was 69 months (5.8 years, range 0.4-29.7 years).
  
  
  METHODS
  Patients were identified using the Australian and New Zealand Ophthalmic Surveillance Unit. A chart analysis was performed for all patients. Three treatment groups were identified: no treatment, prednisolone monotherapy, or combination of prednisolone and immunosuppression. Negative binomial regression was used to calculate incidence rate ratios for patient relapse.
  
  
  METHODS
  Patient demographics, clinical features, associated systemic diseases, treatments administered and dates of relapse.
  
  
  RESULTS
  The disease prevalence in Australia and New Zealand is 1 case per 1.5 million people. Five cases (28%) had a positive QuantiFERON. A total of 32 relapses were observed: 14 while receiving no treatment, 11 on prednisolone and 7 on combination therapy. Compared with the no treatment group, the incidence rate ratio for prednisolone monotherapy and combination therapy was 1.29 and 2.92, respectively (95% confidence interval 0.40-4.14 and 0.96-8.88).
  
  
  CONCLUSIONS
  Although the confidence intervals indicate that the difference in incidence rate ratios are not significant, these results suggest that there is a group of patients who have a benign course without long-term immunosuppression or corticosteroid treatment.
authors: Department of Surgery, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Ophthalmology, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia; Nursing and Health Science, Monash University Faculty of Medicine, Melbourne, Victoria, Australia.
authors: Jason
authors: J
authors: Toniolo
authors: Anthony J
authors: AJ
authors: Hall
authors: Jo
authors: J
authors: Sims
authors: Samantha
authors: S
authors: Fraser-Bell
authors: Jane
authors: J
authors: Khan
authors: Christine
authors: C
authors: Younan
authors: Brian
authors: B
authors: Kent-Smith
authors: Stephanie
authors: S
authors: Young
authors: Eldho
authors: E
authors: Paul
authors: Lyndell L
authors: LL
authors: Lim
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002833:Choroiditis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D015331:Cohort Studies; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D044465:White People
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents
keywords: choroiditis; immunosuppression; steroid; uveitis