Punctate inner choroidopathy with atypical presentation

Area of Science:

• Ophthalmology
• Immunology

Background:

• Myasthenia gravis is an autoimmune disorder affecting neuromuscular junctions.
• Ocular manifestations can occur, but punctate inner choroidopathy is rare.

Observation:

• A young Caucasian female with myasthenia gravis presented with acute vision decrease, metamorphopsia, and scotoma.
• Ophthalmological exam revealed characteristic yellow-white lesions in both eyes.
• Fundus autofluorescence and angiography showed specific patterns, and OCT revealed RPE elevations and ellipsoid zone disruption.

Findings:

• The patient was diagnosed with punctate inner choroidopathy.
• Infectious and inflammatory diseases were ruled out through laboratory workup.
• The condition presented with bilateral, distinct retinal lesions.

Implications:

• This case highlights a rare association between myasthenia gravis and punctate inner choroidopathy.
• Prompt diagnosis and increased corticosteroid therapy (prednisone) can lead to favorable visual outcomes.
• Further research may explore the potential autoimmune link and optimal management strategies.