Serpiginous Choroiditis does not always progress within previously hypoperfused areas of choroid

Purpose: Recent clinical reports claim that progression of serpiginous choroiditis, and of other inflammatory diseases developing at the outer retina/ choriocapillary interfacies, takes always (or most often) place within areas of previous choroidal hypoperfusion. We have used Indocyanine green (ICG) choroidal angiography in longitudinal studies, in order to find out whether this is always the case. Methods. A cohort of 12 patients affected by progressive serpiginous choroiditis is currently being followed up in our Uveitis Clinic. Monitoring of the diseese's progression in each petient includes ICG choroidal angiography, repeated at least twice per year, or more often when the disease shows fast progression. Results. While in some cases the diseasewas seen, to progress within areas of previous chronic choroidal hypoperfusion, in other cases (or, in the same patient, in different areas of progression) the disease was seen to advance in healthy areas of choroid - previously (10-20 days before clinical changes) shown normally perfused by ICG observation - while sparing chronically hypoperfused areas. Conclusions. Choroidal hypoperfusion does neither represent in all instances a prerequisite for progression of serpiginous choroidtis, nor a clear warning for impending advancement of the disease. None.