Atypical serpiginous choroiditis.

Patients with serpiginous choroiditis may demonstrate atypical features. In this series 14 (56%) of 53 patients demonstrated either active choroidal neovascularization (13%) or disciform macular scarring (13%). Despite a slight excess of male subjects, five of seven patients with active choroidal neovascularization were female. Three had bilateral disciform disease. All patients with this complication had visual acuity of 6/60 or less. None were able to be successfully treated by photocoagulation. One patient had secondary branch venous obstruction peripherally, associated with retinal neovascularization. Patients with serpiginous choroiditis are at risk of losing central vision from either an acute active lesion in the macula or choroidal neovascularization occurring at the margin of an inactive chorioretinal scar. Serial examination at regular intervals is recommended to rule out the development of possibly treatable choroidal neovascularization in patients with serpiginous choroiditis.