A retrospective study describing the effective exchange of total blood plasma for disease control in the exacerbation of serpiginous choroiditis

Abstract

AbstractIntroductionSerpiginous choroiditis presents with large yellow‐white exudative lesions that occur near the optic nerve papillae, that progresses slowly with repeated relapses and cures. Although infection and autoimmunity have been implicated, the cause is unknown.MethodsA man was diagnosed with serpiginous choroiditis on clinical and other examinations. He started treatment with oral corticosteroids, cyclophosphamide, adalimumab, azathioprine, rituximab, and mycophenolate mofetil. Only the steroids and cyclophosphamide had a therapeutic effect. Plasma exchange was initiated, and the lesions quickly resolved.ResultsDisease control has been maintained by plasma exchange and cyclophosphamide during flare‐ups in the fall and winter, suggesting that plasma exchange is effective in the treatment of serpiginous choroiditis.ConclusionThe reproducible response with each recurrence suggests a strong association between the disease and autoimmunity. Furthermore, that some, as yet unknown, autoantibodies are involved in the pathogenesis of serpiginous choroiditis.