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Kevin Chen, Jesse J Jung, Lawrence A Yannuzzi; A multimodal imaging analysis of the etiologies and visual outcomes of Pattern Dystrophy. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1135.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the etiologies and clinical outcomes associated with pattern dystrophy (PD) with multimodal imaging.
Consecutive cases with the diagnosis of PD followed by a physician (LAY) underwent a comprehensive ophthalmologic examination including visual acuity (VA), color fundus and fundus autofluorescence photographs, infrared reflectance imaging, and spectral domain and enhanced depth optical coherence tomography. Correlations were made between the etiologies of PD and the age at diagnosis, VA at diagnosis and last follow-up, choroidal thickness (CT), subfoveal central macular thickness (CMT), and the number with outer retinal disruption (ORD) of the ellipsoid layer.
81 patients (113 eyes) (42% male) with a mean (±SD) age 72.9 years (±12.6, range 39-92) were diagnosed with PD and had a mean follow-up duration of 40.5 months (±47.7, range 0-280). The etiologies of PD were age-related macular degeneration (AMD), central serous chorioretinopathy (CSCR), epiretinal membrane (ERM) with vitreomacular traction (VMT), and acquired vitelliform macular dystrophy (VMD) with each having an incidence of 55(48.7%), 5(4.4%), 12(10.6%), and 41(36.3%), respectively. The mean VA at diagnosis was 20/77.5, 20/27, 20/65.8, and 20/41.1, and at last follow-up was 20/77.5, 20/29, 20/170, and 20/67.3 for AMD, CSCR, ERM, and VMD, respectively. There was not a significant difference in BCVA at diagnosis and follow-up among the different etiologies of PD (p=0.27, 0.69, 0.28, 0.10, respectively). Mean CT(±SD) was 201.6(±77.5), 255.4(±119.7), 131.3(±73.4), and 240.9(±86.3) for AMD, CSCR, ERM, and VMD, respectively. Mean CMT(±SD) was 311.1(±58.5), 288.6(±70.7), 328.3(±50.5), and 286.4(±52.6) for AMD, CSCR, ERM, and VMD, respectively. The number with ORD was 30(54.5%), 2(40.0%), 5(41.7%), and 20(48.7%) for AMD, CSCR, ERM, and VMD respectively. ERM/VMT had an overall thinner choroid (p<0.005) but there was no difference in overall mean CMT (p=0.06) or number with ORD (p=0.80).
Patients with PD are most likely to have AMD or VMD. Mean initial and final VA remained stable in AMD, CSCR, ERM/VMT, and VMD although ERM/VMT showed a statistically insignificant decrease in final VA. The CMT or the number with ORD was not significantly different among the diagnoses although ERM/VMT did demonstrate a significantly thinner choroid, which along with the VMT, may partially explain the overall decrease in vision.
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