Polymerase chain reaction evaluation of infectious multifocal serpiginoid choroiditis.

PURPOSE: To study infectious agents associated with multifocal serpiginoid choroiditis (MSC) based on polymerase chain reaction (PCR) evaluation and specific anti-microbial therapy.

METHODS

Retrospective review of medical records.

RESULTS

Thirteen patients with MSC were evaluated with PCR for the following organisms: Mycobacterium tuberculosis (MTB), herpes simplex virus 1 (HSV 1), varicella zoster virus (VZV), and cytomegalovirus (CMV). Nine (69.2%) were PCR positive for one or more organisms. Seven (53.8%) were positive for MTB, 3 (23.1%) for CMV (1 positive for both MTB and CMV), and 1 (7.6%) for both HSV 1 and MTB. All 13 patients received anti-TB therapy and corticosteroids. Nine patients completed 6 months follow-up; 6 resolved completely, 2 continued to have active lesions, while 1 CMV PCR-positive patient required additional valgancyclovir therapy.

CONCLUSIONS

TB is the most important etiology for MSC in endemic countries. The role of herpes viruses in MSC remains unclear and needs further investigation.