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Roomasa Channa, Mohamed Ibrahim, Jeong Lee, Yasir Sepah, Afsheen Khwaja, Elham Hatef, Jangwon Heo, Zubir Rentiya, Diana Do, Quan Nguyen; Characterization of Chorioretinal Findings in Multifocal Choroiditis and Punctate Inner Choroidopathy using Enhanced Depth Imaging. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4399.
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Spectral Domain Optical Coherence tomography (SD-OCT) devices using enhanced depth imaging (EDI) provide improved visualization of the choroid. We utilized EDI-OCT to identify characteristic appearances in retina and choroid of eyes with multifocal choroiditis (MFC) and punctate inner choroidopathy (PIC).
Patients diagnosed with either MFC or PIC were scanned with Spectralis® SD-OCT using both regular and EDI modes to allow detailed visualization of retinal and choroidal structures. Scans were reviewed at the Retinal Imaging Research and Reading Center. Two graders independently evaluated each lesion for abnormalities in choroid and retina. In cases of disagreement, a senior grader made the final decision.
6 patients (8 eyes) were included in the study: 4 eyes each with MFC and PIC (median disease duration of 17 and 30 months respectively). 17 lesions in eyes with MFC and 10 lesions in eyes with PIC were identified and reviewed. The choroid was visualized in all 27 lesions using EDI. Review of EDI-OCT scans in eyes with MFC showed that 9 of 17 lesions had choroidal involvement, visualized as hyperreflectivity in the inner choroid, at the level of the choriocapillaris (CC). In 8 lesions, there was no abnormality noted in the choroid. Retinal changes, including RPE elevation and disruption; photoreceptor (PR) disruption were visualized in all 17 lesions. Review of EDI-OCT scans of 10 lesions with PIC showed that 4 lesions had choroidal involvement. Three lesions showed hyperreflectivity in inner choroid; one lesion showed increased space between Bruch’s membrane (BM) and CC. Six lesions had no choroidal involvement. Retinal abnormalities including RPE disruption, RPE elevation with sub-RPE collection, and PR disruption were visualized in all lesions.
Our novel study shows that EDI-OCT identifies changes at the level of inner choroid in PIC and MFC. Additional studies may help to confirm if EDI-OCT can provide non-invasive means of diagnosing and managing these diseases. Although PIC and MFC are mainly choroidopathies, our study shows that retina is affected more frequently than choroid in both diseases.
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