Serpiginous choroiditis is a bilateral inflammatory disease of unknown cause that represents a pathologic affliction of the retinal pigment epithelium, choriocapillaris, and inner choroid. There is a disruption of the overlying neurosensory retina, marked by periods of activity with intervening intervals of quiescence.
It typically occurs in young to middle-aged white people.
Acute lesions have a gray-white or yellow appearance that begin around the optic nerve or the posterior pole and advance centrifugally by recurrences, to the midperiphery, in an irregular serpentine fashion, leading to scarring and choroidal atrophy. They may result in choroidal neovascular membrane in as many 25% of patients. Given the unpredictability of the disease progression, the fovea is never truly safe from eventual involvement.
Differential Diagnosis
Acute posterior multifocal placoid pigment epitheliopathy
