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Beitragstitel Bilateral ocular melanocytosis-like fundus presentation in patients with sectorial relative pachychoroid: case reports of six patients
Autor:innen
  1. Ioannis Papasavvas Centre for Ophthalmic Specialised Care (COS), Montchoisi Teaching Centre, Lausanne Switzerland Präsentierende:r
  2. Vasileia Chatzistergiou RétinElysée
  3. Jean-Antoine Pournaras Centre Médical RétinElysée
  4. Jean Vaudaux Centre Médical RétinElysée
  5. Aude Ambresin Swiss Visio Montchoisi and Swiss Visio retina Research Center, Lausanne, Switzerland
Präsentationsform ePoster
Themengebiete
  • Retina Vitreous
Abstract-Text Purpose:To present cases with bilateral asymmetrical fundus pigmentation resembling bilateral isolated ocular melanocytosis associated with sectorial relative pachychoroid.Methods: RétinElysée electronic database was used to identify cases presenting an ocular melanocytosis-like fundus image. Complete ophthalmic examination was performed including best corrected vision acuity (BCVA) and dilated fundoscopy. Wide field color images (Optos®, Optomap) and Spectral Domaine Optical Coherence Tomography (SDOCT) using the EDI (enhanced depth imaging) system (Spectralis, Heidelberg inc®) were performed for each patient. Infracyanine dye angiography (ICG) was performed in 5 out of 6 patients. Results: Twelve eyes of 6 patients presented an asymmetrical coloration of the fundus with dense ocular pigmentation of the temporal and/or supero-temporal retina and light coloration of the nasal retina. Mean logMar BCVA was 0.1 ± 0.17, mean age was 45±12 years old. Nine eyes (75%) were myopic (range -1.00 to -4.00D) and 9 eyes were astigmatic (range -1.25 to -4.00D). In all eyes, focal areas of relative pachychoroid were revealed by EDI SDOCT collocated with the zone of dark coloration of the retina, as thin choroid was found under the light-colored retina. Tilted disc was found in most eyes (11/12 eyes, 92%). Seven eyes (58%) had secondary pigment epitheliopathy at the border of the choroidal thickening, 3 eyes (25%) had an associated serous retinal detachment (SRD) from which 1 eye presented sub macular fluid Central Serous Chorioretinopathy (CSC). One eye (8%) had inferior parapapillary neovascularization. In 4 eyes (33%) the sectorial relative pachychoroid was in superior area, 8 eyes in superior-temporal. When performed, ICG revealed in all eyes a zone of sectorial hypoperfusion in the infero-nasal quadrant. Conclusion: Patients with asymmetrical fundus pigmentations, often associated with tilted disc, should be carefully examined or referred for SDOCT exam to search for the presence of concomitant sectorial relative pachychoroid. Asymmetry of coloration between the light nasal retina and dark temporal retina should not be misdiagnosed as ocular melanocytosis. The association of focal epitheliopathy at the margin of the change in choroidal thickness with subretinal fluid and/or secondary choroidal neovascularization suggest a mechanical stress of the pigment epithelium and choriocapillaris above that margin that may lead to complications resembling pachychoroid diseases