Enhanced depth imaging optical coherence tomography and multicolour imaging features in bilateral isolated choroidal melanocytosis

Agrawal

Reddy

et al. 2022

JCM

We report on a case series that revealed flat, choroidal lesions on optical coherence tomography (OCT) and on enface MultiColor® (MCI) imaging of the fundus but were not noticeable on clinical examination or conventional color fundus images. This observational study included 12 eyes from 11 patients who had distinct, orange-colored lesions on MCI. Retinal imaging was conducted using conventional color fundus photography and OCT. On the color fundus images and the blue and green reflectance channels of MCI, each of the lesions was difficult to distinguish. On the infrared channel, the lesion was identified as bright white in color and bright orange on the multicolor image. The lesion was identified on OCT as a flat, homogeneous hyperreflective lesion involving the choroid, with an intact overlying retinal pigment epithelium and retinal layers. A comparison of the clinical and imaging features with other known entities led to the conclusion that the lesion was a distinct clinical entity. The presence of melanin in the lesion was confirmed based on the retinal imaging findings and the light absorption properties of melanin. As a result, the lesion was named as ‘choroidal melanocytic hamartoma’. A longer follow-up is required to confirm the benign nature of this clinical entity.

Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Choroidal Melanocytic Hamartoma

Agrawal

Reddy

et al. 2022

JCM

“…Thus, giving an impression of apparent increased choroidal thicknessat the area of hypopigmentation in choroidal melanocytosis. 8,9 Even in our series of cases, the choroidal structure and vasculature was not clearly delineated in the region of hyperpigmentation while the choroidal structure was better visible in the hypopigmented areas adjacent to the circumpapillary pigmentation.Thus, the findings were more resemblantof an isolated choroidal melanocytosis. However, in this series, the age of detection of these lesionswas in the older age group and of circumpapillary location; contrary to what has been described in literature.…”

Section: Np42contrasting

confidence: 57%

“…7 The classical enhanced depth imaging SDOCT and multicolour imaging features in bilateral isolated choroidal melanocytosis has been described in our previous publications by the author. 8,9 This entity shares many common features with the current series of cases, including stable clinical appearance, visible choroidal vessels, absence of serous retinal detachment and symptoms, unaffected visual acuity and systemic health and characteristic SDOCT features. In the previous papers, the authors had noticed increased reflectivity and poor distinction of choroidal stroma and vessels at the pigmented area due to increased melanin content in the stroma.…”

Section: Np42mentioning

confidence: 55%

Bilateral idiopathic choroidal hyperpigmentation

European Journal of Ophthalmology

Reddy

Cherry

et al. 2021

Self Cite

Purpose: To report a series of cases showing bilateral circumpapillary hyperpigmentation on routine fundus examination. Methods: In this observational case series, three patients showing bilateral circumpapillary hyperpigmentation on routine fundus examination were included. Multimodal retinal imaging was done for these cases. Results: Multimodal imaging of the lesion showed the hyper pigmentation to be confined to the choroid. The optical coherence tomography scans described the features through the hyperpigmented area, adjacent hypopigmented area and the normally pigmented area of the fundus as suggestive of choroidal hyper melanosis. Follow-up of these lesions over a period of 2–6 years showed no change in the vision or characteristics of the lesion. Conclusion: Bilateral circumpapillary hyperpigmentation needs to be considered as a differential for bilateral peripapillary pigmented lesions.

“…Based on this theory, a recent paper from our group explained an apparent increase in choroidal thickness in the depigmented areas of the fundus in a patient with choroidal melanocytosis. [ 9 21 ] Thereby, one would expect the choroid to be thicker in the albinotic patients as well. However, our study showed contrary results where the choroid was significantly thinner than the control group.…”

Section: Discussionmentioning

confidence: 99%

Choroidal and retinal thickness variations in ocular albinism

Agrawal²,

Reddy³

et al. 2022

Indian J Ophthalmol

Self Cite

Purpose: To study the retinal and choroidal thickness variations on enhanced depth imaging optical coherence tomography scans in ocular albinism (OA) and compare with age-matched healthy subjects. Methods: This retrospective observational study had 48 eyes of 24 patients diagnosed clinically as OA and age, sex, and axial length-matched control healthy subjects. All patients underwent detailed ophthalmic examination and a single-line horizontal-raster enhanced depth imaging – optical coherence tomography scan (Spectralis, Heidelberg Engineering). Retinal and choroidal thickness was measured, compared, and analyzed between the two groups. Mann–Whitney U test was used for analysis between the two groups. P < 0.05 was considered significant. Results: The mean age was 28.3 ± 11.6 and 29.9 ± 10.6 years in the OA group and control group, respectively. Spherical equivalents ranged from −8.5D to +10.5D in the OA group and from −8.0D to +10.0D in the control group. The mean axial length between the two groups ( P = 0.652) were comparable. The average retinal thickness (272 ± 34.3 vs. 213 ± 13.8 mm; P < 0.001) was greater in the OA group as compared to controls. The mean choroidal thickness (184 ± 78.4 vs. 287 ± 46.4 mm; P < 0.001) was significantly thinner in the OA group. Conclusion: Acquisition of OCT scans in OA can be challenging. This study showed that the subfoveal retinal thickness and choroidal thickness measured across the scans were significantly different in the OA group compared to controls. In the future, more studies are required to evaluate the role of the choroid and its relationship to emmetropization in albinism.