Optical Coherence Tomography Features Of Multifocal Choroiditis

Abstract

 

Purpose:

 

Multifocal choroiditis is a chronic inflammatory disorder, common in middle-aged women, characterized by multiple punched-out chorioretinal lesions at the posterior pole, and panuveitis. Comparatively little is known about the histopathologic features of this disease. In this report, we use optical coherence tomography (OCT) to evaluate the morphology of a cohort of patients with this disease.

 

Methods:

 

Clinical and imaging data were collected from patients with a diagnosis of multifocal choroiditis, attending a tertiary referral uveitis clinic over a two month period. For inclusion in the study, patients were required to have had spectral domain OCT imaging performed using "enhanced depth" protocols designed to aid choroidal visualization. All OCT image sets were obtained using a single Spectralis OCT system (Heidelberg Engineering, Germany). OCT images were qualitatively assessed for a number of retinal and choroidal features. Quantitative analyses were also performed using image analysis software. Clinical and demographic data collected included age, gender, ethnicity, visual acuity, disease status (active vs. quiescent), and current treatment.

 

Results:

 

Eight eyes (8 patients) were assessed. Mean patient age was 50 +/- 13 years. Mean logMAR visual acuity was 0.35 +/- 0.26. Three patients had "active" disease, while five patients had "quiescent" disease. Mean retinal thickness in the foveal central subfield was 294 +/-96 microns in patients with active disease and 207 +/- 85 in patients with quiescent disease. Mean choroidal thickness in the foveal central subfield was 261 +/-85 microns in patients with active disease and 222 +/- 70 in patients with quiescent disease.

 

Conclusions:

 

In patients with active multifocal choroiditis, the choroid appears thickened and the large vessels of Haller’s layer commonly appear engorged. In some patients, a thin hyporeflective layer may be seen external to the choroid consistent with fluid in the suprachoroidal space. No pathognomonic features were seen on spectral domain OCT, but future studies using long-wavelength OCT systems may address this issue by providing increased depth resolution for improved visualization of the choroid and sclera.

 

Keywords: uveitis-clinical/animal model • image processing • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)