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Published on: December 17, 2021
Pathological findings of multifocal choroiditis with panuveitis and punctate inner choroidopathy
Hiroyuki Shimada1, Mitsuko Yuzawa2, Tokihito Hirose2
1Department of Ophthalmology, School of Medicine, Nihon University, Tokyo, Japan. sshimada@olive.ocn.ne.jp.
Purpose:
To compare the pathological findings between multifocal choroiditis with panuveitis (MCP) and punctate inner choroidopathy (PIC).
Methods:
Fourteen eyes of 14 patients clinically diagnosed as having MCP or PIC who underwent surgical excision of choroidal neovascularization (CNV) were studied. Immunohistochemical findings of the excised CNV in MCP (eight eyes) and PIC (six eyes) cases were compared. Antibodies against vascular endothelial growth factor (VEGF), CD68, CD3, and CD20 were used as primary antibodies.
Results:
Expression of VEGF and CD68 in the CNV was observed in all MCF and PIC cases. In three of eight eyes with MCP, intraocular inflammatory findings were found clinically, while immunohistochemical study demonstrated infiltration of CD20-positive B lymphocytes in the CNV. No B lymphocyte infiltration was found in the six eyes with PIC. No differences in pathological findings were found between the five MCP eyes without intraocular inflammation and the six PIC eyes, with all eyes showing no B lymphocyte infiltration.
Conclusions:
In MPC cases showing clinical inflammatory findings, infiltration of B lymphocytes was also observed histopathologically, suggesting that the presence of inflammatory cells in the anterior chamber or vitreous body clinically is an indicator of active inflammatory CNV. However, this study clarifies that MCP eyes without intraocular inflammation and PIC eyes are not different in histopathological findings.
Insights
Multifocal choroiditis with panuveitis (MCP) shows B lymphocyte infiltration in active inflammation, unlike punctate inner choroidopathy (PIC). However, MCP without inflammation is histopathologically similar to PIC.
Area of Science:
- Ophthalmology
- Immunology
- Pathology
Background:
- Multifocal choroiditis with panuveitis (MCP) and punctate inner choroidopathy (PIC) are inflammatory eye conditions.
- Distinguishing between MCP and PIC can be challenging, impacting treatment strategies.
Purpose of the Study:
- To compare the histopathological findings of choroidal neovascularization (CNV) in MCP and PIC.
- To determine if B lymphocyte infiltration differentiates MCP from PIC.
Main Methods:
- Surgical excision and immunohistochemical analysis of CNV from 14 eyes (8 MCP, 6 PIC).
- Antibodies used: vascular endothelial growth factor (VEGF), CD68, CD3, and CD20.
- Clinical assessment of intraocular inflammation was correlated with pathological findings.
Main Results:
- VEGF and CD68 expression were present in CNV of all MCP and PIC cases.
- B lymphocyte infiltration (CD20+) was found in the CNV of 3 MCP eyes with clinical inflammation.
- No B lymphocyte infiltration was observed in PIC eyes or in MCP eyes without clinical inflammation.
Conclusions:
- Clinical inflammation in MCP correlates with histopathological B lymphocyte infiltration in CNV.
- MCP eyes without clinical inflammation exhibit similar histopathological findings to PIC eyes.
- These findings suggest active inflammation is key to differentiating MCP and PIC histopathologically.
