RAJAN SINGH SIMAR
Fundus photographs are commonly used to describe and monitor disease activity in patients with choroiditis. MCI is fast replacing true colour imaging. However, the utility of MCI in detecting disease activity and complications in choroiditis compared to colour fundus photography (CFP) is not known
In a prospective study, patients with choroiditis underwent concurrent imaging on MCI and CFP to compare the two modalities against the gold standard of multimodal imaging. Images were analysed for several parameters by experts who were blinded to the diagnosis or clinical details. Sensitivity and specificity were calculated for each finding on CFP, MCI, infrared reflectance, green reflectance and blue reflectance images.
This study included 70 eyes of 41 patients with choroiditis in different stages of healing. CFP was found to be superior to MCI in the detection of Epiretinal membranes (Sensitivity of 100% CFP versus 20% on MCI); choroiditis(Sensitivity of 100% on CFP versus 91.4% on MCI); disease activity (Sensitivity of 100% on CFP in active and inactive choroiditis versus 55.31% on MCI in active choroiditis and 91.3% on MCI in inactive choroiditis); intraretinal fluid (Sensitivity of 25% CFP versus 5% on MCI); intraretinal haemorrhage (Sensitivity of 100% CFP versus 0% on MCI) subretinal fibrosis (Sensitivity of 100% CFP versus 68% on MCI) ; scarring and atrophy (Sensitivity of 96.8% CFP versus 84.1% on MCI) ; choroidal neovascularization (Sensitivity of 33% CFP versus 11% on MCI).
MCI was not able to detect disease activity in active choroiditis and is a poor tool as it may lead to misinterpretation at presentation and follow-up of disease and thus experts may be cautious in making their decision based on this imaging modality alone.