Abstract

A diabetic 47 year old male presented with poor vision of 6/36 in the right eye. Fundus suggested active serpiginous choroiditis lesions in the posterior pole. Fundus fluorescein angiography confirmed the same. QuantiFERON TB gold test was negative. Montoux was  positive. With clinical suspicion for Tuberculosis, anti-tubercular therapy (ATT) was started along with intravitreal dexamethasone implant(ozurdex) since patient was intolerant to steroids due to uncontrolled blood sugars. Given that lesions progressed despite this treatment, A second dose of ozurdex along with an extended regimen of ATT was advised after a period of 6months. We succeeded in inactivating the inflammatory process. Vision improved to 6/9 .Adjuvant ozurdex implant along with ATT  maybe beneficial in the management of progressive lesions of serpiginous choroiditis where systemic corticosteroid therapy is contraindicated like in hyperglycemic patients.