Abstract
ObjectiveThis study aims to describe changes in high-resolution spectral domain optical coherence tomography (SD-OCT) scans with simultaneous fundus autoflorescence (FAF) signals in tubercular serpiginouslike choroiditis (SLC).MethodsSimultaneous SD-OCT and FAF imaging of eyes affected with SLC from acute stage until resolution of lesions was obtained using Spectralis HRA+OCT system (Heidelberg Engineering, Heidelberg, Germany).PatientsFour eyes (three patients) with SLC were prospectively followed.ResultsAcute lesions of SLC (diffusely hyperautofluorescent) corresponded to hyperreflective areas on SD-OCT involving the retinal pigment epithelium (RPE), photoreceptor outer segment tips (POST), inner segment–outer segment (IS/OS) junction, external limiting membrane (ELM), and outer nuclear layer (ONL) with a minimal distortion of inner retinal layers. There was no backscattering from inner choroid. During healing, lesions became discrete with a hypoautofluorescent border and predominant hyperautofluorescence centrally. The hyperreflective fuzzy areas on SD-OCT scans disappeared, and irregular, knobbly elevations of outer retinal layers appeared. The RPE, POST, IS/OS junction, and ELM could not be distinguished. The ONL appeared normal. The choroid showed an increased reflectance. As the lesions healed further over the next 3–6 months, they became predominantly hypoautofluorescent with loss of RPE, POST, IS/OS junction, and ELM in SD-OCT scan.ConclusionThe SD-OCT provided an insight into the ultrastructural changes in the outer retina during the course of acute SLC lesions. The changes on OCT correlated with abnormal FAF findings.
Highlights
There was no backscattering from inner choroid
We describe the changes in high-resolution spectral domain optical coherence tomography (SD-OCT) scans that were simultaneously obtained with FAF signals on Spectralis HRA+OCT in four eyes of three patients with serpiginouslike choroiditis (SLC) who were followed from the stage of acute lesion to the healed stage over a period of 3–6 months
During the course of the disease in patients with SLC, we observed a progressively changing pattern on SD-OCT scans that was consistent with the abnormal FAF signals detected simultaneously
Summary
During the course of the disease in patients with SLC, we observed a progressively changing pattern on SD-OCT scans that was consistent with the abnormal FAF signals detected simultaneously. The SD-OCT passing through the area showed a localized, fuzzy area of hyperreflectivity in the outer retinal layers involving the RPE, photoreceptor outer segment tips (POST), photoreceptor inner segment–outer segment (IS/OS) junction, external limiting membrane (ELM), and the outer nuclear layer (ONL). AS anterior segment, SLC serpiginouslike choroiditis, TST tuberculin skin test, M male, CF counting fingers, ND not done, AF autofluorescence, SD-OCT spectral domain optical coherence tomography, RPE retinal pigment epithelium, POST photoreceptor outer segment tips, IS–OS junction inner segment–outer segment junction, ELM external limiting membrane, ONL outer nuclear layer while remaining predominant hyperautofluorescent centrally. Left eye imaging showed a similar pattern of FAF and SDOCT changes during acute, healing, and healed stages of the lesions (Fig. 2d–f)
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