Abstract
Purpose :
It is recognized that the retina overlying congenital hypertrophy of the retinal pigment epithelium is atrophied. However, published data on the underlying choroid is conflicting. This study evaluates and characterizes the choroid underlying congenital hypertrophy of the retinal pigment epithelium (CHRPE).
Methods :
Consecutive patients with CHRPE of at least 2mm in diameter seen at Memorial Sloan Kettering Cancer Center were retrospectively reviewed. Choroidal vascular architecture was qualitatively examined. Choroidal thickness was measured by two independent observers using enhanced depth imaging spectral domain optical coherence tomography (EDI SD-OCT). Choroidal thickness was measured at the most central imaged point of the CHRPE and compared to the normal adjacent choroid 500µm outside the CHRPE border.
Results :
46 eyes (25 right, 21 left) of 46 patients with CHRPE were included. CHRPE were located in the macula-equator in 5, equator in 10, equator-ora in 29 and ora in 2. 28 lesions had no intrinsic lacunae. 43 had characteristic optical halo at the lesions edge. CHPRE had three border configurations: round in 29, scalloped in 13, and torpedo in 3. 32 lesions had optical coherence imaging sufficient for analysis. Haller’s layer was normal in 18 (56%), thin in 13 (41%) and absent in 1 (2%). Sattler’s layer was atrophied in 30 (94%) and the choriocapillaris was atrophied in 31 (97%). The mean sub-CHRPE choroidal thickness was 82.4 +/- 7.9 µm, compared to a thickness of 148.4 +/- 9.6 µm in the normal adjacent choroid (p<0.0001). The mean retinal thickness overlying the CHRPE was 77.3 +/- 4.3 µm, compared to a retinal thickness of 137.8 +/- 2.9 µm overlying the normal adjacent choroid (p<0.0001). The sub-CHRPE choroidal thickness was a mean of 56.2% of the adjacent normal choroidal thickness and the retinal thickness overlying the CHRPE was a mean of 56.3 +/- 3.1% of the adjacent retina in the area outside of the CHRPE.
Conclusions :
The choroid underlying CHRPE is thinner than the adjacent normal choroid. All layers of the choroid can be thinned with a preference of the inner Sattler’s and choriocapillaris layers.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.