Characterization of macular lesions in punctate inner choroidopathy with spectral domain optical coherence tomography

Bilateral multifocal posterior pole lesions in Reiter syndrome

Reactive arthritis is associated with conjunctivitis or iritis. Rarely reactive arthritis is accompanied by permanent visual loss from macular infarction or foveal scarring. We present the case of a rheumatologist who had a sudden onset of skin lesions, arthritis of several joints and bilateral visual loss. Most of these manifestations resolved after a course of oral corticosteroids. However he was left with decreased vision in the left eye and multiple lesions in the fovea over a follow-up of 2 years.

Resolution of acute photoreceptor damage as revealed by serial SD-OCT

PURPOSE

To describe findings in spectral-domain optical coherence tomography (SD-OCT) for four patients with acute foveal photoreceptor damage.

CASE REPORT

Four patients with acute foveal photoreceptor damage were evaluated by color photography and SD-OCT during follow-up. All four cases were Japanese patients with high myopia. Three were women aged 28, 29, and 46 years and one was a boy aged 17 years. The follow-up ranged from 2 weeks to 3 months. On presentation, four eyes had orange-yellow foveal granularity with visual acuities that varied from 1.2 to 0.5. Spectral-domain optical coherence tomography revealed a disrupted photoreceptor layer. All patients achieved spontaneous resolution without treatment within a few months. Of the four eyes, only one had recurrence of the disease.

CONCLUSIONS

Lesions exhibiting orange-yellow foveal granularity characteristic of these four cases corresponded to hyperreflective localized photoreceptor lesions on SD-OCT. Spectral-domain optical coherence tomography was useful for detecting an acute disruption and a resolution of the photoreceptor layer in the fovea.

The relationship between axial length and choroidal thickness in eyes with high myopia

PURPOSE

To investigate the choroidal thickness in highly myopic eyes with no history of choroidal neovascularization or ocular surgery, and to correlate it with axial length, age, and spherical equivalent.

DESIGN

Retrospective, comparative, noninterventional case series.

METHODS

A total of 120 eyes of 83 patients with high myopia (spherical equivalent ≥-6 diopters or axial length ≥26 mm) and 96 eyes of 62 healthy patients were studied in a clinical setting. Eyes with prior vitreoretinal surgery or laser or anti-vascular endothelial growth factor therapy were excluded. Eyes were imaged using optical coherence tomography employing a 6-mm line, reference position "Choroid," and image averaging 50. Choroidal thickness was manually measured from the posterior edge of the retinal pigment epithelium to the choroid-scleral junction at 500-μm intervals up to 2500 μm nasal and temporal to the fovea. Statistical analysis was performed.

RESULTS

The high myopia group mean age was 54.4 ± 18.2 years (range, 18-99) and mean axial length was 29.17 ± 2.44 mm (range, 26.00-35.63). Mean macular choroidal thickness was 115.5 ± 85.3 μm (range, 6.9-436.0). The choroid was thickest temporally (134 μm), then subfoveally (130 μm), and was thinnest in the nasal area (68 μm). This pattern differed markedly from the control eyes. In the high myopia group, axial length had the best correlation with choroidal thickness (r = -0.740; P < .001). Choroidal thickness decreased 25.9 ± 2.1 μm for each additional millimeter.

CONCLUSIONS

Axial length is especially associated with choroidal thickness in high myopia. Choroidal thickness profile in highly myopic patients differs from that in emmetropic patients.