Characterization of macular lesions in punctate inner choroidopathy with spectral domain optical coherence tomography

PURPOSE: Punctate inner choroidopathy (PIC) is an ocular inflammatory disease. Spectral domain optical coherence tomography (SD-OCT) allows detailed visualization of retinal and choroidal structures. We aimed to describe the retinal changes on SD-OCT associated with PIC lesions localized in the macula. METHODS: Retrospective case series: PIC lesions not associated with choroidal neovascularization (CNV) and captured by macular SD-OCT scans were identified and characterized. RESULTS: Twenty-seven PIC lesions from seven patients (eight eyes) were identified and classified into four categories according to disease activity and temporal changes. Among clinically inactive patients, two main patterns were noted on OCT: (1) retinal pigment epithelium (RPE) elevation with sub-RPE hyper-reflective signals and (2) localized disruption of outer retinal layers with choroid and Bruch's membrane (BM) generally spared. Clinically active patients demonstrated lesions with intact BM with RPE elevation that fluctuated with disease activity and sub-RPE hyper-reflective signals. Photoreceptor-associated bands on SD-OCT (PRs) were not visible during active disease, but returned to normal visibility when lesions were clinically stable. Seven lesions in patients without clinically detected activity demonstrated alteration of RPE elevation. CONCLUSION: SD-OCT can provide detailed structural characteristics of PIC lesions. RPE elevation is noted in many lesions while BM and choroid are spared. Photoreceptor-associated bands on SD-OCT appear compressed during clinically active stages and are visible during stabilization. OCT may provide information on activity not detected clinically. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s12348-011-0054-6) contains supplementary material, which is available to authorized users

Illicit deals in cultural objects as crimes of the powerful

Research with dealers at the market end of the global chain of supply of cultural objects leads to the suggestion that the analytical framework associated with the concept of ‘crimes of the powerful’ can be useful in helping us to understand the role of dealers in driving the market, and in focussing our attention on the difficulties of engaging with the illicit trade through a conventional criminal justice approach. This paper explores the nature of the power that is associated with high-level antiquities dealers, and considers its regulatory implications