title: Choroidal granulomas visualized by enhanced depth imaging optical coherence tomography.
abstract: OBJECTIVE
  To assess the visualization of choroidal granulomas (CG) by enhanced depth imaging optical coherence tomography (EDI-OCT) and to describe their EDI-OCT characteristics.
  
  
  METHODS
  Combined indocyanine green (ICG) angiography and EDI-OCT images of 44 CG (sarcoid, tubercular, or Vogt-Koyanagi-Harada related) were reviewed. By ICG angiography, CG were classified as full thickness or partial thickness and as small or large. Two independent operators evaluated EDI-OCT scans over granulomas to record their characteristics (full thickness/partial thickness, shape, reflectivity, internal pattern, margins, and shadowing/increased transmission effect). The agreement between ICG angiography and EDI-OCT, the interobserver agreement, and the correlations between EDI-OCT features and lesion size or disease were studied.
  
  
  RESULTS
  Enhanced depth imaging optical coherence tomography could visualize 100% of CG detected on ICG. Lesions resulted full thickness in 90.9% and 77.3% of the cases on ICG angiography and EDI-OCT, respectively (K = 0.5). All CG were more homogeneous and showed increased transmission of the optical coherence tomography signal as compared with the surrounding choroid. Choroidal granulomas angiographic size influenced lesions characteristics on EDI-OCT. Large granulomas were more likely to be full thickness, round shaped, with defined margins, lower reflective than the surrounding structures, and with internal homogenous pattern. The type of disease significantly influenced CG shape and pattern. Most of tubercular-related lesions showed lobulated shape and nonhomogeneous internal pattern.
  
  
  CONCLUSIONS
  Enhanced depth imaging optical coherence tomography is suitable to visualize CG and to describe their characteristics. Choroidal granulomas size and disease influence lesions appearance on EDI-OCT. Increased transmission effect could be helpful for CG identification.
authors.affiliation: *Department of Clinical Sciences and Community Health, University of Milan, Ophthalmological Unit, IRCCS-Cà Granda Foundation-Ospedale Maggiore Policlinico, Milan, Italy; †Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy; ‡Eye Unit, Immunology Ocular Unit, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy; and §Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Invernizzi
authors.forename: Chiara
authors.initials: C
authors.lastname: Mapelli
authors.forename: Francesco
authors.initials: F
authors.lastname: Viola
authors.forename: Mario
authors.initials: M
authors.lastname: Cigada
authors.forename: Luca
authors.initials: L
authors.lastname: Cimino
authors.forename: Roberto
authors.initials: R
authors.lastname: Ratiglia
authors.forename: Giovanni
authors.initials: G
authors.lastname: Staurenghi
authors.forename: Amod
authors.initials: A
authors.lastname: Gupta
mesh_terms: D002829:Choroid / Q000098:blood supply; D015862:Choroid Diseases / Q000175:diagnosis* / Q000209:etiology; D004396:Coloring Agents; D005451:Fluorescein Angiography; D006099:Granuloma / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007208:Indocyanine Green; D015588:Observer Variation; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications; D041623:Tomography, Optical Coherence / Q000379:methods*; D014392:Tuberculosis, Ocular / Q000150:complications; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications
chemical_list: D004396:Coloring Agents; D007208:Indocyanine Green