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Serpiginous choroiditis, also known as geographic helicoid peripapillary choroidopathy (GHPC), is a rare, chronic, progressive, and recurrent bilateral inflammatory disease involving the retinal pigment epithelium (RPE), the choriocapillaries, and the choroid. [1] It affects adult men and women equally in the second to seventh decades of life. [2]
However, it may definitely be related to other diseases included in the white dot syndrome group. Acute zonal occult outer retinopathy occurs in young to middle age adults and may eventually progress to retinal cell death. Symptoms include acute visual field loss and photopsias. Suspected causes include autoimmune, viral, and fungal. [2] [5]
The etiology of multiple evanescent white dot syndrome is currently unknown but two potential origins have been postulated. Gass, et. al. suggests a virus invades retinal photoreceptors through cell-to-cell transmission via either the ora serrata or optic disc margin. [3]
Serpiginous, first known to be used in the 15th century, is a term from Latin serpere (“to creep”), usually referring to a creeping, snakelike or slowly progressive skin disease. [ 1 ] [ 2 ]
Chorioretinitis is often caused by toxoplasmosis and cytomegalovirus infections (mostly seen in immunodeficient subjects such as people with HIV/AIDS or on immunosuppressant drugs). [3] Congenital toxoplasmosis via transplacental transmission can also lead to sequelae such as chorioretinitis along with hydrocephalus and cerebral calcifications.
Other virus infections that have been linked to BACM are those caused by Parainfluenza, Coxsackievirus, Adenovirus, Echovirus, and Mycoplasma pneumonia. [1] Viral myositis after viral infections may also occur in adults, and viruses, such as COVID-19, have been reported as a rare cause of myositis.
The most common cause of infection in children is a congenital abnormality such as pyriform sinus fistula. [5] In most cases, the infection originates in the piriform sinus and spreads to the thyroid via the fistula. [7] In many reported cases of AIT the infection occurs following an upper respiratory tract infection.
TORCH syndrome is a cluster of symptoms caused by congenital infection with toxoplasmosis, rubella, cytomegalovirus, herpes simplex, and other organisms including syphilis, parvovirus, and Varicella zoster. [1] Zika virus is considered the most recent member of TORCH infections. [2]