Macular retinal and choroidal thickness in unilateral relentless placoid chorioretinitis analyzed by swept-source optical coherence tomography

Abstract

BackgroundThe purpose of this study is to evaluate the retinal and choroidal thickness of the macular region in patients with unilateral relentless placoid chorioretinitis (RPC) and macular involvement. Patients diagnosed with RPC affecting only one eye underwent a comprehensive ophthalmologic examination including best-corrected visual acuity (BCVA), axial length (AL) measurement, slit-lamp examination, and color fundus and autofluorescence photography. The macular region was scanned by swept-source optical coherence tomography in the 1,050-nm wavelength. Automated segmentations of the retina and the choroid were used to obtain the corresponding thickness values.ResultsA total number of three patients (two men and one woman; age range 17 to 62 years) were included. Eyes with clinically evident RPC had a mean AL of 24.62 ± 0.11 mm, whereas in the clinically healthy fellow eyes, the mean AL was 24.65 ± 0.03 (p = 0.70). The mean BCVA was 0.93 ± 0.16 in eyes with RPC, and 1.0 in all the fellow eyes (p = 0.70). Slit-lamp examination did not reveal any sign of vitreous inflammation in any cases. The mean macular retinal thickness was 288.10 ± 10.22 μm in eyes with RPC, and 300.30 ± 7.17 μm in the healthy fellow eyes (p = 0.20). The mean central choroidal thickness was 260.70 ± 140.60 μm in eyes with RPC, and 262.30 ± 123.10 μm in the fellow eyes (p = 0.99). The mean macular choroidal thickness was 248.60 ± 128.40 and 255.10 ± 123.60 μm, respectively (p = 0.99).ConclusionsThe pathogenesis of RPC remains unknown. No changes in the retinal and choroidal thickness were observed in the macular area of eyes diagnosed with RPC with macular involvement compared with the asymptomatic healthy fellow eyes. Further prospective studies are warranted in order to investigate the role of the choroid in cases of RPC.

Optical coherence tomography angiography in uveitis

“…This inner choroidal involvement as prominent feature is supported by the ICGA findings of hypofluorescent areas corresponding to the lesions observed on FFA [51,52,56,57]. OCT imaging manifests increased inner choroidal hyporeflectivity or lucency [52,58], ellipsoid zone disruption and sub-RPE drusenoid abnormalities with RPE atrophy ensuing in the course of the disease, all of which co-localize with the primary zone of choroidal hypoperfusion [1,59]. OCTA imaging confirmed that hypothesis of inner choroidal or choriocapillaris flow reduction, as it illustrates true choriocapillaris flow-void areas that correspond to the ICGA hypofluorescent spots and are of the same or larger size.…”

“…OCTA imaging confirmed that hypothesis of inner choroidal or choriocapillaris flow reduction, as it illustrates true choriocapillaris flow-void areas that correspond to the ICGA hypofluorescent spots and are of the same or larger size. These findings are not artifacts, since they are not associated with signal attenuation or blockage due to overlying RPE alterations [1,23,[58][59][60][61][62][63]. Other studies have also showed progressive recovery of blood flow with reduction of the ill perfused area and evidence of vascular reperfusion [1,59,60,62].…”

Swept-source optical coherence tomography imaging of macular retinal and choroidal structures in healthy eyes

“…After pupil dilation with 0.5 % tropicamide and 0.5 % phenylephrine, a 3D raster scan protocol with 3 um axial resolution and a speed of 100,000 A-scans per second was performed to acquire the retinal and choroidal thickness map in the macular region (12 × 9 mm) with a central fixation. Next, the thickness maps were overlapped to the EDTRS grid (6 × 6 mm) to obtain the values for each sector [ 3 , 11 ]. Built-in software was used to automatically calculate thickness values in the modified EDTRS grid [ 3 ].…”

Relentless Placoid Chorioretinitis: A Case Series of Successful Tapering of Systemic Immunosuppressants Achieved with Adalimumab

“…Clinical features include creamy white retinal lesions that resembles those of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis [1, 2, 3]. RPC patients pose prolonged periods of widespread lesions [4], which may appear and disappear anterior to the equator, developing into numerous (>50) atrophic lesions [1, 2, 3]. Systemic corticosteroids are usually administered for RPC treatment, with subsequent healing and visual acuity improvement.…”

“…Systemic corticosteroids are usually administered for RPC treatment, with subsequent healing and visual acuity improvement. However, the recurrence is common during systemic corticosteroid tapering [1, 2, 3].…”