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Pachyvitelliform maculopathy: an optical coherence tomography analysis of a novel entity.

Authors :
Hilely, Assaf
Au, Adrian
Won Ki Lee
Levin, Miri Fogel
Zur, Dinah
Romero-Morales, Veronica
Santina, Ahmad
Jong Suk Lee, Anat
Loewenstein, Anat
Sarraf, David
Source :
British Journal of Ophthalmology; May2024, Vol. 108 Issue 5, p753-759, 7p
Publication Year :
2024

Abstract

Purpose To describe the optical coherence tomography features of pachyvitelliform maculopathy (PVM), an acquired vitelliform lesion (AVL) associated with pachychoroid disease. Methods This study was a retrospective, multicentre, observational analysis. Medical records and multimodal imaging were reviewed in all patients with pachychoroid disease and AVL. Visual acuity, central choroidal thickness (CCT), AVL dimensions, total choroidal area, luminal choroidal area, stromal choroidal area and choroidal vascular index were measured in all eyes with PVM and compared with normal age-matched control eyes. Results Mean age of the PVM group (17 eyes of 17 patients) was 71.41 years. Average follow-up was 33.15 months. Baseline VA was 20/40 in the PVM group and declined to 20/100 (p=0.006). AVLs were all detected overlying pachyvessels with optical coherence tomography and were all hyperautofluorescent with fundus autofluorescent imaging. Mean CCT in the PVM group was significantly greater (352.35 µm) than the CCT in the control group (226.88 µm, p<0.001). Retinal pigment epithelium (RPE) disruption was present in 64.71% of eyes with PVM at baseline and 41.18% developed macular atrophy at the end of follow-up. Conclusions PVM, defined by the presence of AVL associated with pachychoroid features, is a distinct novel entity of the pachychoroid disease spectrum. This study suggests a possible pathogenesis of RPE dysfunction secondary to a thick choroid, leading to accumulation of undigested photoreceptor outer segments and AVL. Clinicians should be aware of this common cause of vitelliform lesions and the poor visual prognosis due to the high risk of atrophy development. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
00071161
Volume :
108
Issue :
5
Database :
Complementary Index
Journal :
British Journal of Ophthalmology
Publication Type :
Academic Journal
Accession number :
177470406
Full Text :
https://doi.org/10.1136/bjo-2022-322553