Clinical case: Serpiginous-like choroiditis with macular involvement and good response after treatment with adalimumab.

Clinical case of a 42-year-old woman who consulted for decreased vision in the left eye over two months, associated with multifocal choroiditis. Different diagnostic tests were performed to rule out infectious pathologies, as well as a diagnostic vitrectomy test, which was negative. QuantiFERON® was found to be positive and a diagnosis of serpeginous-like choroiditis (SLC) was made. Anti-tuberculosis treatment was started with worsening of vision and multifocal choroiditis. Once conventional immunotherapy and biological treatment were added, the patient presented a significant improvement in vision. To conclude, in cases of CSL, it is not only necessary to treat the infection but also the inflammatory component either with steroids or conventional immunotherapy or immunosuppression with biologics, thus reducing the number of reactivations and improving the visual prognosis.

Caso clínico: coroiditis serpiginosa-like con afectación macular y buena evolución tras tratamiento con adalimumab / Clinical case: Serpiginous-like choroiditis with macular involvement and good response after treatment with adalimumab

Se presenta el caso clínico de una mujer de 42 años, que consultó por disminución de visión del ojo izquierdo de 2 meses evolución, asociada a coroiditis multifocal. Se realizaron diferentes pruebas diagnósticas para descartar enfermedad infecciosa, al igual que se realizó una vitrectomía diagnóstica, que resultó negativa. Se encontró QuantiFERON® positivo y se realizó el diagnóstico de coroiditis serpiginosa-like (CS-L). Se inició tratamiento antituberculoso con empeoramiento de la visión y de la coroiditis multifocal. Una vez que se agregaron inmunoterapia convencional y tratamiento biológico, la paciente presentó mejoría significativa de la visión. Para concluir, en casos de CS-L no solo es necesario el tratamiento de la infección, sino también del componente inflamatorio, sea con inmunoterapia convencional o inmunosupresión con biológicos, y así disminuir el número de reactivaciones mejorando el pronóstico visual (AU)

Clinical case of a 42-year-old woman who consulted for decreased vision in the left eye over 2months, associated with multifocal choroiditis. Different diagnostic tests were performed to rule out infectious pathologies, as well as a diagnostic vitrectomy test, which was negative. QuantiFERON® was found to be positive and a diagnosis of serpiginous-like choroiditis (SLC) was made. Anti-tuberculosis treatment was started with worsening of vision and multifocal choroiditis. Once conventional immunotherapy and biological treatment were added, the patient presented a significant improvement in vision. To conclude, in cases of SLC, it is not only necessary to treat the infection but also the inflammatory component either with steroids or conventional immunotherapy or immunosuppression with biologics, thus reducing the number of reactivations and improving the visual prognosis (AU)