Multimodal Imaging Analysis of Punctate Inner Choroidopathy
OBJECTIVE To analyze the multimodal imaging characteristics of patients with punctate inner choroidopathy.METHODS A total of five patients(nine eyes)diagnosed with punctate inner choroidopathy at the Department of Ophthalmology,First Affiliated Hospital of Xi'an Jiaotong University,from April 2017 to November 2022 were included.The cases included one instance each of multiple evanescent white dot syndrome(MEWDS),punctate inner choroidopathy(PIC),acute posterior multifocal placoid pigment epitheliopathy(APMPPE),relentless placoid chorioretinitis(RPC),and multifocal choroiditis with panuveitis(MCP).Visual acuity,intraocular pressure,slit-lamp examination,fundus photography,and optical coherence tomography(OCT)were performed before and after treatment.Patients with multiple evanescent white dot syndrome(MEWDS)underwent fundus autofluorescence examination,while patients with punctate inner choroidopathy(PIC),acute posterior multifocal placoid pigment epitheliopathy(APMPPE),relentless placoid chorioretinitis(RPC),underwent fluorescein angiography(FFA).Indocyanine green angiography(ICGA)was performed for APMPPE and RPC patients,and optical coherence tomography angiography(OCTA)was conducted for patients with multifocal choroiditis and panuveitis(MCP).RESULTS The imaging manifestations of various diseases in punctate inner choroidopathy are both similar and different.(1)PIC:Active lesions showed high autofluorescence and early hyperfluorescence on FFA,with late leakage and eventual retinal choroidal atrophy.Lesions appeared as multiple weakly fluorescent spots on ICGA.OCT revealed focal hyperreflectivity of the retinal pigment epithelium(RPE)layer with corresponding disruption of the outer retina and RPE atrophy.(2)MCP:Atrophic lesions exhibited low autofluorescence,while active lesions showed mild hyperfluorescence.FFA revealed progressive punctate hyperfluorescence with areas of window defect.ICGA showed weakly fluorescent spots.(3)MEWDS:Lesions exhibited high autofluorescence.FFA showed a"wreath-like"pattern of hyperfluorescent dots,and ICGA revealed weakly fluorescent spots.OCT showed disrupted ellipsoid zone and occasionally hyperreflective round lesions on the RPE and/or vertical linear hyperreflectivity in the outer nuclear layer.(4)APMPPE:Lesions exhibited low autofluorescence in the acute phase and later high autofluorescence.FFA showed early hypofluorescence,late high fluorescence,and ICGA demonstrated larger areas of hypoperfusion than FFA.OCT revealed disrupted ellipsoid zone with localized hyperreflective points.(5)RPC:Spotty changes with low autofluorescence in the posterior pole.Early hypofluorescence on FFA,late high fluorescence,and ICGA showed persistent hypofluorescence.When lesions involved the fovea,OCT revealed subretinal fluid and detachment of the retinal pigment epithelium with hyperreflective material in the retina.CONCLUSIONS Multimodal imaging techniques contribute to a better understanding of the nature of the disease,enabling precise diagnosis and formulation of rational treatment and follow-up plans.
NETL
NSTL
万方数据
