The Clinical Characteristics Of Primary Inflammatory Choriocapillaropathies

Objective To investigate the clinical features of PICCP andprovide theoretical basis for its clinical diagnosis andtreatment.Methods One hundred and thirteen patients (139eyes) whichwere diagnosed in the second hospital of JiLin University fromJanuary2010to January2013were studied retrospectively.Among these patients,31patients (41eyes) were male,82patients (98eyes) were female. The age，gender，visual acuity,clinical symptoms and fundus imaging of each patient wererecorded. All eyes were examined by slit lamp, including theanterior chamber,vitreous and fundus. All the patients weretaken fundus photograph, AF images, FFA images,ICGA imagesand OCT images.Result1. A total of113cases of PICCP were enrolled in thisstudy,46cases were MEWDS,26cases were MFC,15cases wereSPC,12cases were PIC,7cases were AIBSE,7cases were APMPPE.Respectively accounting for PICCP in the proportion of thetotal number was40.7%、23.0%、13.3%、10.6%、6.2%and6.2%.2. The age distribution of PICCP：The patients’age of MEWDSvaried from17to53.The average age of the patients was35.Age of MFC varied from16to72.The average age was44. Age of SPC varied from22to71.The average age was46.5. Age ofPIC varied from18to59.The average age was38.5. Age of AIBSEvaried from18to37.The average age was27.5.Age of APMPPEvaried from20to78.The average age was49. According to ourstudy, young and middle-aged people appear to be more proneto be suffered with PICCP.3. The gender distribution of PICCP： Among the patients ofMEWDS,9patients were male,37patients were female. Amongthe patients of MFC,8patients were male,18patients werefemale. Among the patients of PIC,1patient were male,11patients were female. Among the patients of AIBSE,1patientwere male,6patients were female. Among the patients ofAPMPPE,2patients were male,5patients were female. In ourstudy, female are more prone to these diseases than male.4. Among the patients of MEWDS,46cases were unilateraleye.Among the patients of MFC,14cases were bilateral eyes,12cases were unilateral eye. Among the patients of SPC,8caseswere bilateral eyes,7cases were unilateral eye. Among thepatients of PIC,12cases were unilateral eye. Among thepatients of AIBSE,7cases were unilateral eye. Among thepatients of APMPPE,4cases were bilateral eyes,3cases wereunilateral eye. In our study, MEWDS, PIC and AIBSE mostly affect mono-ocular, while MFC, SPC and APMPPE are mostly affectbilateral eyes.5.Five cases of MEWDS were complicated with CNV, accountingfor MEWDS disease in the proportion of the total number was10.9%. Five cases of MFC were complicated with CNV, accountingfor MFC disease in the proportion of the total number was19.2%.Three cases of SPC were complicated with CNV, accounting forSPC disease in the proportion of the total number was20.0%.Eight cases of PIC were complicated with CNV, accountingfor PIC disease in the proportion of the total number was66.7%.6.(1)The intensities of FAF increased in the acute phaseof disease, while in the postacute phase,the intensities ofFAF decreased.(2)In the acute phase of these diseases, FAshowed early hypofluorescence and late hyperfluorescentareas went from faint to profuse. In the postacute phase, therewere zones of alternating areas of window effects and maskingeffects.(3)In the acute phase of disease, early ICGA showedhypofluorescence,intermediate and late angiographic framesbut were usually more clearly visible on the late frames afterpartial wash-out of ICG from choroid. In the postacute phase,ICGA hypofluorescent areas represented choroidal atrophy andscarring; there were hyper fluorscent ICGA rims around progressing lesions.(4)In the acute phase of disease, OCTrevealed disturbances and interruptions in the photoreceptorinner/outer segment junction, thinning of the outer nuclearlayer. Clinically active patients demonstrated lesions withintact BM with RPE elevation that fluctuated with diseaseactivity and sub-RPE hyper reflective signals. In thepostacute phase, OCT showed interruptions of the photoreceptorinner/outer segment junction and thinning of retina. Sub-RPEhyper reflective signals disappeared gradually.Conclusion To recognize and categorize the clinical featuresof PICCP is significant for the treatment and prognosis of thisdisease.