Adalimumab as an alternative treatment in Serpiginous Choroiditis

Purpose Serpiginous Choroiditis is a type of chronic bilateral posterior uveitis, with a geographical pattern that begins in the juxtapapillary zone and spreads in an intermittent and centrifugal manner. The purpose is to describe an alternative treatment for SC based on Adalimumab monotherapy. Methods A female patient with decreased visual acuity in the last 6 months of the left eye and characteristic lesions in the ocular fundus of SC with juxtapapillary and paramacular involvement. The disease continued its course despite treatment with Prednisone at high doses, and affected the contralateral eye with small foci. Disease control was achieved by triple therapy of Prednisone, Azatriopine and Cyclosporin but the patient started with side effects derived from the treatment. Due to the immunological basis and supported on the literature, treatment with Adalimumab and decreasing doses of Prednisone was instituted. Results After 8 months of follow up, the patient presents a good control of the disease, besides the improvement of the secondary effects derived from the previous treatment. Conclusions Adalimumab may be a good alternative in cases of CS that are not controlled despite the maximum treatment with triple therapy, or in which the treatment can not be continued due to side effects or poor compliance.