Optical Coherence Tomography Findings of Underlying Choroidal Neovascularization in Punctate Inner Choroidopathy.

Aniruddha Agarwal,Alessandro Marchese,Roel J Erckens,Reema Bansal,C A B Webers,Alessandro Invernizzi,Salvatore Parrulli,Vishali Gupta,Tos T J M Berendschot,Sabia Handa

doi:10.3389/fmed.2021.758370

Abstract

Purpose: To analyze findings on optical coherence tomography (OCT) suggestive of choroidal neovascularization (CNV) in lesions of punctate inner choroidopathy (PIC).Methods: In this multi-center retrospective study, clinical data of patients with PIC were retrospectively analyzed. Quantitative data (height, width, and volume of PIC lesions), and qualitative data (disruption of ellipsoid zone (EZ)/Bruch's membrane (BM), outer retinal fuzziness, and choroidal back-shadowing) were compared between CNV+ and CNV– groups using Mann–Whitney U-test and Fischer's exact test.Results: In total, 35 eyes (29 patients; 21 women; mean age: 33.3 ± 6.5 years) were selected for analysis. Of the 35 PIC lesions studied, 17 had underlying CNV. Lesions with CNV+ had larger height, width, and volume (p < 0.001) and several distinctive features, such as disruption of EZ and BM, outer retinal fuzziness, and hypo-reflective back-shadowing (p < 0.001) compared with CNV—lesions.Conclusions: Quantitative and qualitative OCT analysis can aid in the prediction of an underlying CNV in the eyes with PIC.

Highlights

Punctate inner choroidopathy (PIC) is a rare form of posterior uveitis characterized by multifocal yellow-white choroidal lesions that appear punctate, discrete, and well-demarcated
Sub-retinal pigment epithelial (RPE) cell deposit (34%), and localized RPE elevation (19%). The latter two patterns present either with sub-RPE hyper-reflective material or subretinal hyper-reflective material (SHRM). These patterns are relevant because an underlying choroidal neovascularization (CNV), which is very common in untreated eyes of PIC, can present
The diagnosis of PIC was established based on clinical features of the typical disease, which consist of multifocal, small (1/4–1/2 disc diameter,

Summary

Introduction

Punctate inner choroidopathy (PIC) is a rare form of posterior uveitis characterized by multifocal yellow-white choroidal lesions that appear punctate, discrete, and well-demarcated. The authors described three patterns of OCT in patients with PIC, namely atrophic pattern with outer retinal disruption (47%), OCT and OCTA in PIC sub-retinal pigment epithelial (RPE) cell deposit (34%), and localized RPE elevation (19%). The latter two patterns present either with sub-RPE hyper-reflective material or subretinal hyper-reflective material (SHRM). These patterns are relevant because an underlying CNV, which is very common in untreated eyes of PIC, can present

Methods

Results

Conclusion