Spectral-domain optical coherence tomographic findings in punctate inner choroidopathy

To investigate the pathology of punctate inner choroidopathy (PIC) using spectral-domain optical coherence tomography.

We retrospectively reviewed spectral-domain optical coherence tomography findings of 14 cases with active PIC. We obtained specific appearance of the active PIC lesion that were characterized by yellowish/white round spots in fundus examination with fluorescein leakage. Fluorescein angiogram and confocal indocyanine green angiogram were also reviewed.

Three cases (21%) of 14 were found to have specific findings. Case 1 was a 33-year-old woman who showed old choroidal neovascularization and active PIC. Spectral-domain optical coherence tomography showed multiple pigment epithelial detachments with hyperreflective contents and an irregular faint hyperreflective signal at the outer retina. The blurred vision resolved without treatment, at which time all the pathologies resolved. Case 2 was a 42-year-old woman who showed previously treated choroidal neovascularization and active PIC. Spectral-domain optical coherence tomography disclosed small retinal pigment epithelium breaks through which sub-retinal pigment epithelium material migrated into the outer retina. The patient was observed, and the best-corrected visual acuity improved. Case 3 was a 32-year-old woman who showed obsolete PIC. Spectral-domain optical coherence tomography disclosed a retinal pigment epithelium defect.

Multiple pigment epithelial detachments filled with hyperreflective material presumed to be because of inflammatory product and faint signals at the outer retina are common in active phase of PIC. These signs disappear according to the resolution of acute phase.