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Retrospective analysis of the natural history and management of serpiginous choroiditis in A ustralia and N ew Z ealand
Author(s) -
Toniolo Jason,
Hall Anthony J,
Sims Jo,
FraserBell Samantha,
Khan Jane,
Younan Christine,
KentSmith Brian,
Young Stephanie,
Paul Eldho,
Lim Lyndell L
Publication year - 2014
Publication title -
clinical and experimental ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.3
H-Index - 74
eISSN - 1442-9071
pISSN - 1442-6404
DOI - 10.1111/ceo.12283
Subject(s) - medicine , prednisolone , immunosuppression , rate ratio , incidence (geometry) , retrospective cohort study , confidence interval , pediatrics , surgery , physics , optics
Background To examine the prevalence of serpiginous choroidopathy in a predominantly C aucasian 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. Design Retrospective cohort study with patients from tertiary care centres and private practices. Participants 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 A ustralian and N ew Z ealand O phthalmic S urveillance U nit. 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. Main Outcome Measures Patient demographics, clinical features, associated systemic diseases, treatments administered and dates of relapse. Results The disease prevalence in A ustralia and N ew Z ealand 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). Conclusion 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.