title: Characterization of punctate inner choroidopathy using enhanced depth imaging optical coherence tomography.
abstract: OBJECTIVE
  To perform qualitative and quantitative analyses of retinal and choroidal morphology in patients with punctate inner choroidopathy (PIC) using enhanced depth imaging optical coherence tomography (EDI-OCT).
  
  
  METHODS
  Cross-sectional, consecutive series.
  
  
  METHODS
  A total of 2242 patients attending 2 tertiary referral uveitis clinics at Moorfields Eye Hospital were screened; 46 patients with PIC diagnosis were identified, and 35 eyes (35 patients) had clinically inactive PIC had EDI-OCT images that met the inclusion criteria.
  
  
  METHODS
  Punctate inner choroidopathy lesions were qualitatively assessed for retinal features, such as (1) focal elevation of the retinal pigment epithelium (RPE), (2) focal atrophy of the outer retina/RPE, and (3) presence of sub-RPE hyperreflective deposits and choroidal features: (a) presence of focal hyperreflective dots in the inner choroid and (b) focal thinning of the choroid adjacent to PIC lesions. Quantitative analyses of the retina, choroid, and choroidal sublayers were performed, and associations with clinical and demographic data were examined.
  
  
  METHODS
  Prevalence of each lesion pattern and thickness of retinal and choroidal layers.
  
  
  RESULTS
  A total of 90 discrete PIC lesions were captured; 46.6% of PIC lesions consisted of focal atrophy of the outer retina and RPE; 34.4% consisted of sub-RPE hyperreflective deposits; and 18.8% consisted of localized RPE elevation with underlying hyporeflective space. Focal hyperreflective dots were seen in the inner choroid of 68.5% of patients, with 17.1% of eyes presenting focal choroidal thinning underlying PIC lesions. By excluding high myopes, patients with "atypical" PIC had reduced retinal thickness compared with patients with "typical" PIC (246.65±30.2 vs. 270.05±24.6 μm; P = 0.04), and greater disease duration was associated with decreases in retinal thickness (r = -0.53; P = 0.01). A significant correlation was observed between best-corrected visual acuity and foveal retinal thickness (r = -0.40; P = 0.03).
  
  
  CONCLUSIONS
  In a large series of patients with clinically inactive PIC, one fifth of the lesions analyzed revealed RPE elevation with underlying hyporeflective space, described before as a sign of activity and suggesting subclinical inflammation. Retinal thickness seems to be associated with disease type and duration of disease in non-highly myopic eyes. Improved visualization of the inner choroid using EDI-OCT may allow noninvasive assessment of inflammatory status.
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Zarranz-Ventura
authors.affiliation: NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Dawn A
authors.initials: DA
authors.lastname: Sim
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Pearse A
authors.initials: PA
authors.lastname: Keane
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Praveen J
authors.initials: PJ
authors.lastname: Patel
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Westcott
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom; Uveitis Service, Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Lee
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.
authors.forename: Adnan
authors.initials: A
authors.lastname: Tufail
authors.affiliation: Medical Retina Service, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom; NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom. Electronic address: Carlos.Pavesio@moorfields.nhs.uk.
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Pavesio
mesh_terms: D000328:Adult; D002825:Chorioretinitis / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D041623:Tomography, Optical Coherence / Q000379:methods*; D014605:Uveitis / Q000175:diagnosis; D014792:Visual Acuity; D055815:Young Adult