Punctate inner choroidopathy and optic neuropathy: simultaneous presentation in a patient - a case report

We present a case of a patient initially presenting with multifocal choroiditis (MFC) in one eye. She subsequently developed lesions most consistent with punctate inner choroidopathy (PIC) in the contralateral eye, followed by acute vision loss from retrobulbar optic neuropathy. Optic neuropathy has been well described in the setting of MFC. There is, however, only one report of its association with PIC. Punctate inner choroidopathy and MFC have many similarities, with visual loss generally resulting from choroidal neovascularization. In this case, the patient had significant visual loss from presumed retrobulbar optic neuropathy.

The patient responded well to immunomodulation with subsequent return of vision to baseline.

Multifocal choroiditis and punctate inner choroidopathy may be a spectrum of the same disease with many overlapping presentations, including optic neuropathy. Good visual recovery and remission were attained with mycophenolate mofetil and systemic corticosteroid treatment.