This patient was seen initially with inactive peripapillary and macular chorioretinal scarring from serpiginous choroiditis.
A year and a half later, he presented with new subfoveal active inflammation. One year later, there was inactive atrophic subfoveal scarring.
Learning Points:
Serpiginous choroiditis is an idiopathic, usually bilateral chorioretinal inflammatory condition most commonly found in middle-aged men.
Recurrent areas of inflammation develop along the edge of a previous scar, producing scarring that meanders from the optic nerve outward into the macula.
Vision is good unless scarring (as in this patient) or macular neovascularization extends through the macular center.
