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R Joel Welch, Thamolwan Surakiatchanukul, Carol L Shields; Multimodal imaging characteristics of solitary idiopathic choroiditis in 26 cases. Invest. Ophthalmol. Vis. Sci. 2017;58(8):1855. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The term solitary idiopathic choroiditis (SIC) was coined in 2002 to describe a small (approximately one disc diameter), yellow-white choroidal lesion found in the peripapillary region of the eye and of unknown etiology. In this retrospective, observational case series, we further characterize SIC by investigating multimodal imaging characteristics including enhanced depth imaging optical coherence tomography (EDI-OCT).
Review of chart, fundus photography, ultrasonography, fundus autofluorescence (FAF), infrared reflectance (IR) imaging, and EDI-OCT of SIC in 26 cases.
The mean age at diagnosis was 50 years (range, 7–78 years). There were 13 male and 13 female patients. The mean best-corrected visual acuity was 20/25 (range, 20/20–20/150). Clinically, the SIC lesion appeared deep to the retina with overlying retinal pigment epithelial atrophy. The mass demonstrated yellow hue (n=25) with occasional surrounding orange halo (n=10). Mean basal diameter was 2.7 mm (range, 1.0–4.0 mm) and all 26 lesions were found posterior to the equator. Ultrasonography revealed acoustic solidity (n=17) with a mean thickness of 1.8 mm (range, 1.2–3.2 mm). FAF disclosed mild intrinsic hyperautofluorescence (n=17) from unmasking of the scleral autofluorescence and IR imaging displayed hyperreflectivity (n=21). On EDI-OCT, all 26 lesions demonstrated a focal nodular mass arising within the sclera with partial or complete compression of overlying choroidal vasculature to mean choroidal thickness of 39 µm (range, 0-122 µm). By EDI-OCT, mean lesion diameter was 2977 µm (range, 1864–4587 µm).
Solitary idiopathic choroiditis generally displays ultrasonographic solidity, hyperautofluorescence from scleral unmasking, and hyperreflectivity on IR imaging. By EDI OCT, this lesion localizes predominantly within the sclera and compresses the overlying choroidal vasculature. Based on these observations this condition shows features of a focal scleral nodule moreso than choroiditis and revision of nomenclature is advised.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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