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Published on: August 2, 2013
PUNCTATE INNER CHOROIDOPATHY-LIKE REACTION IN STAGE 3 EXTENSIVE MACULAR ATROPHY WITH PSEUDODRUSEN-LIKE APPEARANCE
Andrea Trinco1, Francesco Romano1,2,3, Alessandro Invernizzi1,4
1Eye Clinic, Department of Biomedical and Clinical Sciences, Ospedale Luigi Sacco, University of Milan, Milan, Italy.
Purpose:
The objective of this study was to describe a rare complication in a patient with extensive macular atrophy with pseudodrusen-like appearance, suggesting immune dysregulation in advanced stages of the disease.
Methods:
This was a case Report. Multimodal imaging-including true-color fundus photography, blue autofluorescence, high-resolution optical coherence tomography, swept source optical coherence tomography angiography, and dye-based angiography-was used to evaluate retinal alterations.
Results:
A 53-year-old woman with Stage 3 extensive macular atrophy with pseudodrusen-like appearance presented with moderately hyperreflective subretinal material colocalizing with a large rupture of the Bruch membrane in the right eye. Multimodal imaging ruled out macular neovascularization, suggesting a diagnosis of punctate inner choroidopathy-like reaction. Treatment with oral steroids led to complete regression of the subretinal inflammatory lesion.
Conclusion:
This case highlights a novel inflammatory complication in extensive macular atrophy with pseudodrusen-like appearance. Our findings emphasize a potential role of immune dysregulation in late-stage extensive macular atrophy with pseudodrusen-like appearance and underscore the value of multimodal imaging in the management and follow-up of these patients.
