Systemic Immunosuppression and Secondary Choroidal Neovascularisation in Patients with Punctate Inner...

Area of Science:

• Ophthalmology
• Immunology
• Retinal Diseases

Background:

• Punctate Inner Choroidopathy (PIC) is a posterior uveitis affecting myopic females.
• Choroidal Neovascularization (CNV) is a significant complication of PIC.
• Understanding treatment efficacy for PIC-related CNV is crucial for visual preservation.

Purpose of the Study:

• To evaluate CNV-free survival, CNV recurrence-free survival, and visual outcomes in PIC patients.
• To compare different immunomodulatory treatment strategies for PIC.

Main Methods:

• A retrospective study of 69 PIC patients (96 eyes) from 2009-2024.
• Patients received no systemic therapy, systemic corticosteroids, or combination therapy (corticosteroids + immunosuppressants).
• Kaplan-Meier analysis and Cox regression were used to assess outcomes and risk factors.

Main Results:

• Incident CNV rates were 12.8% (no therapy), 22.5% (corticosteroids), and 37.5% (combination therapy), with no significant difference.
• No significant differences in CNV recurrence-free survival were observed across treatment groups.
• Pre-existing subfoveal fibrosis/atrophy was a significant risk factor for CNV (HR: 2.89).

Conclusions:

• Systemic immunosuppression does not appear to reduce CNV occurrence or recurrence in PIC.
• Early anti-VEGF treatment is recommended for PIC patients with CNV.
• Further prospective studies are needed to establish optimal PIC management.