Choroidal Vascular Changes in Acute Idiopathic Maculopathy as Demonstrated by Multimodal Imaging including Optical Coherence Tomography Angiography

Figure 1

Wide-field fundus photography of the right eye (A) shows an ovoid, hypopigmented placoid lesion adjacent to the fovea. FAF (B) reveals corresponding hypoautofluorescence and surrounding areas of hyperautofluorescence with irregular borders. Near-infrared reflectance (C) and spectral-domain optical coherence tomography (D) reveal speckled hyperreflectivity within the lesion and significant disruption of the outer retina, including the outer nuclear layer, ellipsoid zone, and retinal pigmented epithelium with choroidal hypertransmission. Early hyperfluorescence with FA (E) precedes increased hyperfluorescence of the macular lesion with discrete borders upon recirculation phase (F). Late-phase indocyanine green angiography shows multiple areas of hypocianescence in the right (G) greater than the left eye (H), including the area corresponding to the lesion. (b) Spectral-domain optical coherence tomography at 6 months after initial presentation shows improved attenuation in the outer plexiform layer.

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