PURPOSE To compare the characteristics of choroidal transmission in punctate inner choroidopathy (PIC) with or without choroidal neovascularization (CNV) and myopic CNV (mCNV) using spectral domain optical coherence tomography (SD-OCT). METHODS This retrospective observational case series includes 22 consecutive myopic patients (22 eyes) recruited from April 2016 until April 2018 who complained of acute blurring of vision and showed evidence of hyper-reflective material on SD-OCT imaging. Each patient underwent a comprehensive eye examination and imaging with fundus fluorescein angiography (FFA), SD-OCT, and SD-OCT angiography (SD-OCTA). Based on the results of SD-OCTA imaging and the color fundus imaging, the patients were divided into 2 groups: a group with myopic choroidal neovascularization (mCNV group, n = 10 eyes) and a group with PIC and no evidence of CNV at baseline (PIC group, n = 12 eyes). Four eyes diagnosed with PIC developed secondary PIC-CNV during follow-up. The characteristics of choroidal transmission in these eyes using SD-OCT imaging were compared. RESULTS At baseline, none of the PIC lesions showed any evidence of blood flow within the lesions on OCTA imaging. However, all of the eyes with mCNV showed flow signals within the subretinal neovascularization on SD-OCTA and subretinal or intra-retinal fluid on SD-OCT imaging. These eyes with mCNV showed subretinal hyper-reflectivity associated with choroidal hypo-transmission accompanied by retinal pigment epithelium (RPE) and ellipsoid zone (EZ) disruption. In eyes with PIC inflammatory lesions, disruption of both the RPE and EZ were observed in 33% of the inflammatory lesions, and disruption of the EZ alone was observed in 67% of the lesions at the baseline. They all showed a hyper-reflective subretinal lesion located above RPE. Three cases (25%) showed evidence of choroidal hyper-transmission at the baseline, while the remaining had normal transmission within the first month after onset. Hyper-transmission then developed in all the lesions as the disease progressed. Four cases of PIC (33%) developed PIC-related CNV that showed choroidal hypo-transmission along with hyper-transmission with disruption of the RPE and EZ. In cases with PIC-related CNV, evidences of neovascularization on SD-OCTA imaging were all detected afterwards. No intra-retinal fluid was detected before secondary CNV occurred. CONCLUSION SD-OCT imaging can noninvasively differentiate and track the progression of inflammatory lesions and myopic CNV by using the presence of choroidal hyper-transmission as a sign of just an inflammatory lesion and the presence hypo-transmission as a sign of a secondary CNV, which provides a convenient strategy for diagnosis and treatment of these lesions.

中文翻译：

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通过SD-OCT成像，是否存在脉络膜超透射，可以将近视眼的炎症性病变与新生血管病变区分开。

目的使用光谱域光学相干断层扫描技术（SD-OCT）比较有或无脉络膜新生血管（CNV）和近视CNV（mCNV）的点状内脉络膜病变（PIC）中脉络膜的传播特征。方法该回顾性观察病例系列包括2016年4月至2018年4月连续入选的22例近视患者（22眼），他们抱怨视力出现急性模糊，并在SD-OCT成像上显示出超反射材料的证据。每位患者均接受了眼底荧光血管造影（FFA），SD-OCT和SD-OCT血管造影（SD-OCTA）的全面眼科检查和影像检查。根据SD-OCTA成像和彩色眼底成像的结果，将患者分为2组：一组近视脉络膜新生血管（mCNV组，n = 10眼）和PIC组，基线时无CNV证据（PIC组，n = 12眼）。在随访期间，四只被诊断为PIC的眼睛发展为继发性PIC-CNV。比较了使用SD-OCT成像在这些眼睛中脉络膜传输的特征。结果基线时，在OCTA成像中，没有PIC病变显示出病变内有血流的任何迹象。但是，所有具有mCNV的眼睛在SD-OCTA上都在视网膜下新血管形成内显示流量信号，而在SD-OCT成像上则在视网膜下或视网膜内液内显示流量信号。这些具有mCNV的眼睛显示出视网膜下反射率高，与脉络膜低透射有关，并伴有视网膜色素上皮（RPE）和椭球区（EZ）破裂。在有PIC炎性病变的眼中，在33％的炎性病变中观察到RPE和EZ均被破坏，在基线时，在67％的病变中仅观察到EZ的破坏。它们都显示位于RPE上方的高反射性视网膜下病变。3例（25％）在基线时显示脉络膜高传递的证据，而其余病例在发病后第一个月内正常传播。然后，随着疾病的进展，在所有病变中都出现了高传播。4例PIC患者（33％）出现与PIC相关的CNV，显示脉络膜低速传输以及超速传输以及RPE和EZ的破坏。在与PIC相关的CNV的病例中，SD-OCTA影像上的新生血管形成的证据随后全部被发现。在继发CNV发生之前未检测到视网膜内液。