Jae Hyung Lee1, Jun Yong Kim, Byung Ju Jung, Won Ki Lee. 1. Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Abstract
PURPOSE: To describe a distinctive focal disruption of the ellipsoid zone (EZ)/interdigitation zone (IZ) determined by spectral-domain optical coherence tomography in eyes with pachychoroid pigment epitheliopathy. METHODS: Twenty patients with focal EZ/IZ disruptions associated with pachychoroid without history or findings indicative of subretinal fluid were evaluated. Detailed clinical/imaging characteristics and their longitudinal changes were evaluated. RESULTS: A total of 27 lesions from 21 eyes were included. The mean subfoveal choroidal thickness was 450 μm. In six of seven eyes with previous imaging data to compare, characteristic drusenoid lesions associated with thick choroid preceded focal EZ/IZ disruptions at the corresponding sites. Dilated outer choroidal vessels were noted beneath the focal EZ/IZ disruption in 24 lesions (88.9%), with attenuation of choriocapillaris in 18 lesions (66.7%). The external limiting membrane was intact in all lesions. All except three eyes did not show morphologic changes, and mean visual acuity was maintained (Snellen equivalent, 20/25) during a mean follow-up period of 20 months. CONCLUSION: Focal disruptions of the EZ/IZ band can develop in pachychoroid eyes in the absence of subretinal fluid, with a stable clinical course, and possibly as a result of regression of drusenoid lesions. This may represent an atrophic form of pachychoroid manifestation.
PURPOSE: To describe a distinctive focal disruption of the ellipsoid zone (EZ)/interdigitation zone (IZ) determined by spectral-domain optical coherence tomography in eyes with pachychoroid pigment epitheliopathy. METHODS: Twenty patients with focal EZ/IZ disruptions associated with pachychoroid without history or findings indicative of subretinal fluid were evaluated. Detailed clinical/imaging characteristics and their longitudinal changes were evaluated. RESULTS: A total of 27 lesions from 21 eyes were included. The mean subfoveal choroidal thickness was 450 μm. In six of seven eyes with previous imaging data to compare, characteristic drusenoid lesions associated with thick choroid preceded focal EZ/IZ disruptions at the corresponding sites. Dilated outer choroidal vessels were noted beneath the focal EZ/IZ disruption in 24 lesions (88.9%), with attenuation of choriocapillaris in 18 lesions (66.7%). The external limiting membrane was intact in all lesions. All except three eyes did not show morphologic changes, and mean visual acuity was maintained (Snellen equivalent, 20/25) during a mean follow-up period of 20 months. CONCLUSION: Focal disruptions of the EZ/IZ band can develop in pachychoroid eyes in the absence of subretinal fluid, with a stable clinical course, and possibly as a result of regression of drusenoid lesions. This may represent an atrophic form of pachychoroid manifestation.
Authors: Gideon Nkrumah; Manuel Paez-Escamilla; Sumit Randhir Singh; Mohammed Abdul Rasheed; Dmitri Maltsev; Abhilash Guduru; Jay Chhablani Journal: Ther Adv Ophthalmol Date: 2020-08-24