BACKGROUND: Punctate Inner Choriodopathy (PIC) is a bilateral ocular inflammatory disease typically affecting healthy young myopic women.
CASE REPORT(S). A 21 year-old WF presented with a chief complaint of rapid onset decreased vision OU with bright spots in her field of vision. Best corrected VA was OD (-7.25D) 20/25 and OS (-8.00) 20/800. Two months prior, the patient suffered a pyrexia of 101.0 F for which no cause was found (pyrexia of unknown origin). Past medical history was unremarkable but family history was positive for a grandfather with ARMD. The patient was not taking medication and had no known drug allergies. Pupils and anterior segment examination was within normal limits. Funduscopic examination showed multiple confluent largely atrophic lesions that were centered around the macula OU. VF testing showed a large paracentral scotoma OD and a central scotoma OS. Although the lesions were confluent, somewhat atypically for PIC, the diagnosis of PIC was made. The patient was subsequently started on 60mg prednisone a day for 2 months and was given a home Amsler grid. A month following cessation of the oral steroids, the patient again noticed a further decrease in vision OD with minor metamorphopsia (OD 20/100 PHNI, OS 20/400). The patient was restarted on prednisone for 3 weeks. Despite initial improvement, the patient's vision continued to deteriorate and was subsequently referred to our low vision services for device evaluation. The patient is currently attending graduate school with the help of handheld magnifiers, high plus bifocal add and telescopes.
CONCLUSIONS. PIC can present in different manners, in this case multiple small circular choroidal lesions surrounding an area of confluent choroidal and pigment epithelial lesions with sparing of a small area of the central macula was manifested. The poster will discuss the various presentations, prognosis and treatment of PIC.