Solitary idiopathic choroiditis: findings on enhanced depth imaging optical coherence tomography in 10 cases

To describe the imaging characteristics of solitary idiopathic choroiditis (SIC).

Retrospective, observational case series.

Ten eyes in 10 patients with SIC.

Review of chart, fundus photography, ultrasonography, fundus autofluorescence (FAF), infrared reflectance (IR) imaging, and enhanced depth imaging optical coherence tomography (EDI OCT).

Scleral, choroidal, and retinal features of SIC as analyzed by EDI OCT.

The mean age at diagnosis was 47 years (range, 7-76 years). There were 4 male patients and 6 female patients. The mean best-corrected visual acuity was 20/25 (range, 20/20-20/150). The SIC lesions were postequatorial (n = 10), with a mean basal diameter of 2.6 mm (range, 1.0-4.0 mm), yellow hue (n = 10), and surrounding orange halo (n = 6). Ultrasonography revealed acoustic solidity (n = 10) with a mean thickness of 1.7 mm (range, 1.4-2.1 mm), FAF disclosed hyperautofluorescence (n = 9), and IR imaging displayed hyperreflectivity (n = 9). On EDI OCT, all 10 lesions were dome shaped with a smooth surface and arose with a gentle slope from the sclera. A more abruptly elevated volcanic configuration was seen in 2 lesions. The overlying choroid was thinned (mean thickness, 32 μm; range, 0-52 μm). The lesions were moderately reflective with an optically bright anterior band and deep shadowing (n = 8). The posterior margin of the lesion could be ascertained in only 1 case. By EDI OCT, the mean diameter was 2942 μm (range, 1887-3809 μm). In no case was there disturbance of the inner retina or subretinal fluid.

Solitary idiopathic choroiditis generally displays ultrasonographic solidity, hyperautofluorescence, and hyperreflectivity on IR imaging. On EDI OCT, the dome-shaped lesion arises from the sclera, outer choroid, or both and the overlying choroidal vasculature is thinned.