A CASE OF PUNCTATE INNER CHOROIDOPATHY: CLINICAL FEATURES AND OUTCOMES

Title A CASE OF PUNCTATE INNER CHOROIDOPATHY: CLINICAL FEATURES AND OUTCOMES
Author, Co-Author Mahsa Salehi, Peter Gehlbach
Topic
Year
2012
Day
Program Number
125673
Room
Exhibit Hall E
Affiliation
Johns Hopkins University School of Medicine, Wilmer Eye Institute
Abstract BACKGROUND: Punctate inner choroidopathy (PIC) is an idiopathic ocular inflammatory disease involving the choroid and retina. It usually presents as multifocal, well-circumscribed small choroidal lesions in the absence of vitreous or anterior chamber inflammation. Choroidal neovascularization is the most common complication and subfoveal CNV accounts for the highest number of poor visual outcome. Papilledema and segmental retinal phlebitis are occasional events. The general visual prognosis is moderately good.

CASE REPORT(S): We report a 32-year-old Caucasian female with chief complaint of blurry vision and metamorphopsia for several months. Ocular and systemic history is unremarkable. Her best-corrected visual acuity measured 20/60 OD and 20/60 OS. Slit lamp examination was noncontributory. Dilated fundus examination found small punched out lesions in the maculae with choroidal neovascular membrane and minor subretinal fluid in both eyes. Baseline serological blood workup was ordered to eliminate any possible infectious or systemic etiology, which found to be normal. Given her inactive disease, she was treated with Cellcept, which is an immunosuppressive agent. Within several months of treatment her vision and distortion was improved and progression of choroidal neovascularization was arrested.

CONCLUSIONS: The diagnosis of PIC can be difficult because many other entities have similar appearance. The active choroidal lesions can be treated with oral or regional immunosuppressive agents and also intravitreal anti-VEGF. Generally PIC carries a good visual prognosis when the diagnosis and treatment are carried out appropriately. We review demographics, presenting symptoms, disease manifestations, differential diagnosis, treatment regimens, and ocular complications associated with this rare disease.
Affiliation of Co-Authors Johns Hopkins University School of Medicine, Wilmer Eye Institute
Outline