TY - JOUR
T1 - Exploring Imaging Characteristics Associated With Disease Activity in Idiopathic Multifocal Choroiditis
T2 - A Multimodal Imaging Approach
AU - de Groot, Evianne L.
AU - ten Dam-van Loon, Ninette H.
AU - Kouwenberg, Carlyn V.
AU - de Boer, Joke H.
AU - Ossewaarde-van Norel, Jeannette
N1 - Funding Information:
Funding/Support: This work was supported by the Dr. F.P. Fischer Foundation, Foundation Beheer het Schild, Landelijke Stichting voor Blinden en Slechtzienden (LSBS), Rotterdamse Stichting Blindenbelangen (RBS), Foundation Louise Rottinghuis, and Oogfonds.
Funding Information:
THE AUTHORS INDICATE NO FINANCIAL SUPPORT OR CONFLICTS OF INTEREST. ALL AUTHORS ATTEST THAT THEY MEET THE CURRENT ICMJE CRITERIA FOR AUTHORSHIP. Funding/Support: This work was supported by the Dr. F.P. Fischer Foundation, Foundation Beheer het Schild, Landelijke Stichting voor Blinden en Slechtzienden (LSBS), Rotterdamse Stichting Blindenbelangen (RBS), Foundation Louise Rottinghuis, and Oogfonds.
Publisher Copyright:
© 2023 The Authors
PY - 2023/8
Y1 - 2023/8
N2 - Purpose: To identify characteristics on multimodal imaging (MMI) in idiopathic multifocal choroiditis (MFC) that can identify inflammatory activity and distinguish choroidal neovascularization (CNV) activity from inflammatory activity. Design: Prospective cohort study. Methods: MMI consisted of spectral-domain optical coherence tomography (angiography) (SD-OCT(A)), fundus autofluorescence, fundus photography, infrared imaging, fluorescein angiography (FA), and indocyanine green angiography (ICGA). MMI characteristics obtained during active and inactive disease were compared within the same lesion. Secondly, MMI characteristics were compared between active inflammatory lesions with and without CNV activity. Results: Fifty patients (110 lesions) were included. In 96 lesions without CNV activity, the mean focal choroidal thickness was increased during the active disease (205 µm) compared to the inactive disease (180 µm) (P ≤ .001). Lesions with inflammatory activity typically demonstrated moderately reflective material located in the sub–retinal pigment epithelium (RPE) and/or in the outer retina with disruption of the ellipsoid zone. During the inactive stage of the disease, the material disappeared or became hyperreflective and indistinguishable from the RPE. During the active stage of the disease, the area of hypoperfusion in the choriocapillaris significantly increased as visualized on both ICGA and SD-OCTA. CNV activity in 14 lesions was associated with subretinal material with a mixed reflectivity and hypotransmission of light to the choroid on SD-OCT and leakage on FA. SD-OCTA identified vascular structures in all active CNV lesions and in 24% of lesions without CNV activity (showing old, quiescent CNV membranes). Conclusion: Inflammatory activity in idiopathic MFC was associated with several MMI characteristics, including focally increased choroidal thickness. These characteristics can guide clinicians in the challenging process of the evaluation of disease activity in idiopathic MFC patients.
AB - Purpose: To identify characteristics on multimodal imaging (MMI) in idiopathic multifocal choroiditis (MFC) that can identify inflammatory activity and distinguish choroidal neovascularization (CNV) activity from inflammatory activity. Design: Prospective cohort study. Methods: MMI consisted of spectral-domain optical coherence tomography (angiography) (SD-OCT(A)), fundus autofluorescence, fundus photography, infrared imaging, fluorescein angiography (FA), and indocyanine green angiography (ICGA). MMI characteristics obtained during active and inactive disease were compared within the same lesion. Secondly, MMI characteristics were compared between active inflammatory lesions with and without CNV activity. Results: Fifty patients (110 lesions) were included. In 96 lesions without CNV activity, the mean focal choroidal thickness was increased during the active disease (205 µm) compared to the inactive disease (180 µm) (P ≤ .001). Lesions with inflammatory activity typically demonstrated moderately reflective material located in the sub–retinal pigment epithelium (RPE) and/or in the outer retina with disruption of the ellipsoid zone. During the inactive stage of the disease, the material disappeared or became hyperreflective and indistinguishable from the RPE. During the active stage of the disease, the area of hypoperfusion in the choriocapillaris significantly increased as visualized on both ICGA and SD-OCTA. CNV activity in 14 lesions was associated with subretinal material with a mixed reflectivity and hypotransmission of light to the choroid on SD-OCT and leakage on FA. SD-OCTA identified vascular structures in all active CNV lesions and in 24% of lesions without CNV activity (showing old, quiescent CNV membranes). Conclusion: Inflammatory activity in idiopathic MFC was associated with several MMI characteristics, including focally increased choroidal thickness. These characteristics can guide clinicians in the challenging process of the evaluation of disease activity in idiopathic MFC patients.
UR - http://www.scopus.com/inward/record.url?scp=85153620918&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2023.03.022
DO - 10.1016/j.ajo.2023.03.022
M3 - Article
C2 - 36972741
AN - SCOPUS:85153620918
SN - 0002-9394
VL - 252
SP - 45
EP - 58
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -