Aim To describe the increasing incidence of multifocal outer retinal and inner choroidal inflammation as a marker for intraocular tuberculosis in the UK, a non-endemic area.

Patients and methods Retrospective case series.

Results 14 patients presented with serpiginous-like choroiditis over 10 years (seven within the last 2 years). Seven of 14 patients showed evidence of exposure to tuberculosis and received antituberculous treatment. 17 of 23 eyes showed stable or improved visual acuity. All with decreased acuity had direct macular involvement at presentation.

Conclusions Multifocal outer retinal and inner choroidal inflammation is a marker for intraocular tuberculosis of increasing importance, even in a non-endemic area. Originally described as ‘serpiginous-like choroiditis’, the lesions are multifocal, irregular in shape, very numerous, widespread, often asymmetrical and often demonstrating both active and resolved lesions simultaneously. Active lesions show contiguous extension. We recommend that every patient with SLC should undergo testing for previous exposure to tuberculosis, and undergo antituberculous treatment if lesions are progressive and sight-threatening.