RPE disruption and hyper-transmission are early signs of secondary CNV with punctate inner choroidopathy in structure-OCT

Yanru Chen,Qian Chen,Minghan Li,Xiaoxin Li

doi:10.1186/s12886-021-02197-7

Yanru Chen, Qian Chen + Show 2 more

Open Access

https://doi.org/10.1186/s12886-021-02197-7

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Journal: BMC ophthalmology	Publication Date: Dec 1, 2021
Citations: 5	License type: open-access

Affiliation: Xiamen University

Abstract

PurposeTo study whether retinal pigment epithelium (RPE) disruption and choroidal hyper-transmission on spectral-domain optical coherence tomography (SD-OCT) are signs of inflammatory neovascularization (CNV) in punctate inner choroidopathy (PIC).MethodsThis is a prospective cohort study. Seventeen patients (18 eyes) were diagnosed as PIC without CNV at baseline. Changes of morphological characteristics including choroidal hyper-transmission, hypo-transmission, RPE disruption, and ellipsoid zone (EZ) damage on SD-OCT were observed and recorded at baseline, 4, 8 and 12 weeks, respectively. The occurrence of CNV was detected by OCTA at each visit. Fisher’s exact test was used to compare the relationship with each morphological sign and evaluate the predictable capability of secondary CNV in PIC (PIC+CNV) based on the structure changes on OCT.ResultsAmong the 18 eyes, a total of 5 eyes (27.8%) developed PIC+CNV subsequently within 4 weeks follow-up. At 4, 8 and 12 weeks of follow-up, RPE disruption and choroidal hyper-transmission were found in all 5 PIC+CNV eyes. The incidence of RPE disruption was significant higher in PIC+CNV eyes compared with PIC eyes (P=0.001). PIC eyes with hyper-transmission had a higher risk for developing CNV compared with those without hyper-transmission (P=1.17×10-3). 2 out of 5 PIC+CNV eyes had a choroidal hypo-transmission component adjacent to hyper-transmission zone at 4 weeks of follow-up, and hypo-transmission could be observed in all 5 PIC+CNV eyes at 8 weeks of follow-up. The incidence of choroidal hypo-transmission was significant higher in PIC+CNV eyes than PIC eyes after 8 weeks. EZ damage began to recover at 4 weeks of follow-up and had no significant difference in the PIC eyes and PIC+CNV eyes (P=0.150, 0.196, 0.353).ConclusionThe presence of choroidal hyper-transmission and RPE disruption on SD-OCT is associated with the PIC+CNV. SD-OCT imaging facilitates the differentiation and track of the progression of inflammatory lesions and secondary CNV in PIC.

Highlights

Punctuate inner choroidopathy (PIC) is an ocular inflammatory disease mostly affecting young myopic women
Patients’ characteristics A total of 17 patients (18 eyes) with PIC who complained of acute blurring of vision within 4 weeks were enrolled in the study
Choroidal neovascularization confirmed by SD-optical coherence tomography angiography (OCTA) was developed in 5 eyes (27.8%) during follow-up

Summary

Introduction

Punctuate inner choroidopathy (PIC) is an ocular inflammatory disease mostly affecting young myopic women. The newly developed optical coherence tomography angiography (OCTA) provides abnormal blood flow signals, which can aid in the differential diagnosis of choroidal neovascularization and inflammation [3]. It is not widely used than optical coherence tomography (OCT) in rural and community hospitals in developing countries [4]. To distinguish the PIC inflammation lesion and secondary CNV, we utilized spectral domain OCT (SDOCT) to study the morphological characteristics of these lesions. It can detect the morphological changes of different layers of the retina and choroid with high sensitivity, specificity and depth resolution. SD-OCT is a good tool to study PIC, which usually affects the level of the deep retina and choroid

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