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Jun 17 2025 by Guilherme Sturzeneker, MD, MSc

Ultra-widefield fundus photograph and autofluorescence of a 33-year-old woman with longstanding serpiginous choroiditis in the right eye. The image reveals centrifugal chorioretinal atrophy forming a dramatic fractal-like pattern, sparing the fovea. The patient is several years post-onset, with repeated negative workups, including for tuberculosis. Despite extensive lesions, the patient retains 20/20 vision in both eyes. Management included azathioprine monotherapy, as systemic steroids were contraindicated due to bipolar disorder.

Photographer: Andrea Almeida, IPEPO - Instituto da Visão

Imaging device: Optos Silverstone

Condition/keywords: autoimmune uveitis, azathioprine, chorioretinal atrophy, serpiginous choroiditis, ultra-wide field imaging