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Raquel Garcia-Cabrera, Javier Zarranz-Ventura, Dawn Sim, Pearse Keane, Catherine Egan, Praveen Patel, Mark Westcott, Richard Lee, Adnan Tufail, Carlos Pavesio; Punctate Inner Choroidopathy characterization by Enhanced Depth Imaging-Optical Coherence Tomography: Qualitative analysis of PIC lesions & relationship with clinical features. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4861.
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To assess qualitative OCT features of Punctate Inner Choroidopathy (PIC) lesions and determine their relationship with clinical data collected from medical records.
Enhanced depth imaging OCT images from patients diagnosed with PIC were collected in two tertiary referral Uveitis clinics at Moorfields Eye Hospital over a 5 month period. Qualitative analysis included assessment of a) Retinal morphology with 1) focal elevation of the RPE, 2) focal atrophy of the outer retina/RPE, and 3) presence of sub-RPE deposits; and b) Choroidal morphology with 1) presence of focal hyperreflective dots in the inner choroid, and 2) focal thinning of the choroid adjacent to PIC lesions
2242 uveitic patients were screened, 46 patients diagnosed with PIC were identified, and 35 eyes (35 patients) had EDI-OCT images that met the inclusion criteria. A total number of 90 PIC lesions were captured by the scans. 46.6% of PIC lesions (42/90) showed disruption of outer retinal layers and RPE atrophy, 34.4% sub-RPE deposits (31/90); and 18.8% consisted of localized RPE elevations (17/90). Untreated eyes presented significantly more sub-RPE deposit lesions than eyes on steroids or immunosuppressive (16/34 (47.0%) vs 15/56 (26.7%), p:0.050). Disruption of outer retinal layers was more prevalent in treated vs untreated eyes (30/56 (53.6%) vs 12/34 (35.3%), p: 0.090). Focal hyperreflective dots were seen in 68.5% of patients, and were more frequently observed in typical PIC than atypical PIC (14/16 vs 11/19, 87.5% vs 57.9%, p:0.053). Focal choroidal thinning associated with PIC lesions was present in 17.1% of eyes, with no differences between disease type, refractive status or treatment type for this particular feature.
Qualitative analysis of OCT features of PIC lesions may provide information about sub-clinical activity of disease, allowing a non-invasive assessment of inflammatory status of these patients
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