Floaters as a presenting sign of choroiditis

Abstract

A 19-year-old man presented with a complaint of floaters in both eyes. On examination, his best-corrected visual acuity was 20/20 in both eyes. The anterior segment examination of both eyes was normal. Fundus examination showed vitreous hemorrhage, with several patches of active and healed choroiditis in both the eyes (A). Systemic investigations included a negative Mantoux test, normal levels of serum angiotensin-converting enzyme, elevated erythrocyte sedimentation rate, and nonreactive HIV I and II antibodies, as well as VDRL. To rule out syphilis, we performed serum ACE testing. The patient was diagnosed with bilateral choroiditis of unknown etiology and treated with oral steroids and azathioprine 50 mg twice a day.  At 3 months’ follow-up, his visual acuity was 20/25 in both eyes. The choroiditis patches resolved (B).