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Punctate inner choroidopathy: clinical features and outcomes
Rohan W Essex1, James Wong, Samantha Fraser-Bell
1Department of Ophthalmology, Canberra Hospital and Australian National University, Australia. rohan.essex@act.gov.au
Insights
Punctate inner choroidopathy (PIC) can lead to vision loss due to choroidal neovascularization. This study found no difference between typical and atypical PIC lesions, suggesting they are part of the same disease spectrum.
Area of Science:
- Ophthalmology
- Medical Research
- Retinal Diseases
Background:
- Punctate inner choroidopathy (PIC) is an idiopathic inflammatory condition affecting the inner choroid.
- Understanding the clinical spectrum and outcomes of PIC is crucial for patient management.
Purpose of the Study:
- To characterize the clinical features and outcomes of a large cohort of patients diagnosed with punctate inner choroidopathy (PIC).
- To investigate differences between typical and atypical presentations of PIC.
Main Methods:
- A retrospective case series included 136 patients with PIC and at least 12 months of follow-up.
- Patients were classified into typical or atypical PIC groups.
- Outcomes assessed included choroidal neovascularization (CNV), new PIC lesions, and final visual acuity.
Main Results:
- 136 patients (271 eyes) were analyzed over a mean follow-up of 6.2 years.
- Choroidal neovascularization developed in 22% of PIC eyes, with 26% experiencing final visual acuity <6/60.
- No significant differences in outcomes were found between typical and atypical PIC presentations.
Conclusions:
- Punctate inner choroidopathy-related choroidal neovascularization poses a significant risk to visual acuity.
- The findings support the classification of typical and atypical PIC lesions as manifestations of a single disease entity.
Objective:
To describe the clinical features and outcomes of a large group of patients with a spectrum of clinical appearances and diagnosed as having punctate inner choroidopathy (PIC).
Methods:
In a retrospective consecutive case series, patients seen during a 16-year period at Moorfields Eye Hospital who were diagnosed as having PIC and had a minimum of 12 months' follow-up were included. Patients were classified as having typical PIC or atypical PIC (larger, presumed ocular histoplasmosis syndrome-like lesions). Main outcome measures included development of choroidal neovascularization, development of new PIC lesions, and final visual acuity.
Results:
A total of 136 patients (271 eyes) were included. The average age was 32 years, 126 patients (93%) were female, and the mean refraction was -4.6 diopters. The overall mean follow-up was 6.2 years. Among 63 normal fellow eyes, 56 (88%) remained unchanged, 3 (5%) developed PIC lesions, and 4 (6%) developed choroidal neovascularization. Eyes with PIC lesions remained unchanged in 49 of 74 cases (66%), with 9 (12%) developing new PIC lesions and 16 (22%) developing choroidal neovascular membrane. In eyes with choroidal neovascularization, the mean logMAR visual acuity was 0.63 at study entry, 0.63 at 12 months, 0.61 at 2 years, and 0.71 at final review (mean, 6.1 years). Overall, 40 eyes with PIC-related choroidal neovascular membrane (26%) had final visual acuity less than 6/60. No differences were observed between typical and atypical PIC eyes in any of the outcome measures or in any of the subgroup analyses.
Conclusions:
Punctate inner choroidopathy-related choroidal neovascularization was not visually benign. No differences were observed between eyes with typical and atypical choroidal lesions, supporting the notion that they represent a spectrum of a single disease, PIC.
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