Abstract
PurposePunctate inner choroidopathy (PIC) is an ocular inflammatory disease. Spectral domain optical coherence tomography (SD-OCT) allows detailed visualization of retinal and choroidal structures. We aimed to describe the retinal changes on SD-OCT associated with PIC lesions localized in the macula.MethodsRetrospective case series: PIC lesions not associated with choroidal neovascularization (CNV) and captured by macular SD-OCT scans were identified and characterized.ResultsTwenty-seven PIC lesions from seven patients (eight eyes) were identified and classified into four categories according to disease activity and temporal changes. Among clinically inactive patients, two main patterns were noted on OCT: (1) retinal pigment epithelium (RPE) elevation with sub-RPE hyper-reflective signals and (2) localized disruption of outer retinal layers with choroid and Bruch's membrane (BM) generally spared. Clinically active patients demonstrated lesions with intact BM with RPE elevation that fluctuated with disease activity and sub-RPE hyper-reflective signals. Photoreceptor-associated bands on SD-OCT (PRs) were not visible during active disease, but returned to normal visibility when lesions were clinically stable. Seven lesions in patients without clinically detected activity demonstrated alteration of RPE elevation.ConclusionSD-OCT can provide detailed structural characteristics of PIC lesions. RPE elevation is noted in many lesions while BM and choroid are spared. Photoreceptor-associated bands on SD-OCT appear compressed during clinically active stages and are visible during stabilization. OCT may provide information on activity not detected clinically.Electronic supplementary materialThe online version of this article (doi:10.1007/s12348-011-0054-6) contains supplementary material, which is available to authorized users.
Highlights
Punctate inner choroidopathy (PIC) is an ocular inflammatory disease mostly affecting young myopic women. It was described by Watzke et al in 1984; diagnosis was based on the visualization of yellowish white punctate lesions on funduscopy apparently in the absence of ocular inflammation [1]. These lesions appeared to be located at the level of the choroid and retinal pigment epithelium (RPE)
Clinic visits during which the patients had Spectral domain optical coherence tomography (SD-Optical coherence tomography (OCT)) measurements were included in the index study
After all observations have been analyzed, we describe the SDOCT characteristics of the lesions in clinically active and clinically stable patients including the temporal changes observed on spectral domain (SD)-OCT in both categories
Summary
Punctate inner choroidopathy (PIC) is an ocular inflammatory disease mostly affecting young myopic women. It was described by Watzke et al in 1984; diagnosis was based on the visualization of yellowish white punctate lesions on funduscopy apparently in the absence of ocular inflammation [1]. These lesions appeared to be located at the level of the choroid and retinal pigment epithelium (RPE). Autofluorescence of PIC lesions in correlation with activity has been described [4]. To date, the exact localization of origin of the lesions is not known
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