DISCIFORM DETACHMENT OF THE MACULA

Abstract

Patients (6) with juvenile hemorrhagic macular choroidopathy were studied with fluorescein and indocyanine green fluorescence (ICG) angiography, and red-light and red-free light photography in different stages of the disease. The primary lesion consisted of multifocal, whitish, dot-like areas of choroidal infiltration showing hyperfluorescence in the late phase of the fluorescein angiograms. Red-light photographs revealed depigmentation of the pigment epithelium overlying the choroidal lesion, and clearly demonstrated the subsequent pigment-ring lesion. Fluorescein angiograms revealed subretinal neovascularization at the site of the disciform-stage choroidal lesion. ICG angiograms revealed the choroidal lesion located in the region of greatest supply of short posterior ciliary arteries, whereas the lesion itself remained underfilled throughout the angiogram suggesting vascular decompensation at the site of the lesion. The results suggested a vascular basis, namely intravascular coagulation in the central choriocapillaris, for this uveitis entity.