Punctate Inner Choroidopathy

Abstract

To describe the clinical features and outcomes of a large group of patients with a spectrum of clinical appearances and diagnosed as having punctate inner choroidopathy (PIC). In a retrospective consecutive case series, patients seen during a 16-year period at Moorfields Eye Hospital who were diagnosed as having PIC and had a minimum of 12 months' follow-up were included. Patients were classified as having typical PIC or atypical PIC (larger, presumed ocular histoplasmosis syndrome-like lesions). Main outcome measures included development of choroidal neovascularization, development of new PIC lesions, and final visual acuity. A total of 136 patients (271 eyes) were included. The average age was 32 years, 126 patients (93%) were female, and the mean refraction was -4.6 diopters. The overall mean follow-up was 6.2 years. Among 63 normal fellow eyes, 56 (88%) remained unchanged, 3 (5%) developed PIC lesions, and 4 (6%) developed choroidal neovascularization. Eyes with PIC lesions remained unchanged in 49 of 74 cases (66%), with 9 (12%) developing new PIC lesions and 16 (22%) developing choroidal neovascular membrane. In eyes with choroidal neovascularization, the mean logMAR visual acuity was 0.63 at study entry, 0.63 at 12 months, 0.61 at 2 years, and 0.71 at final review (mean, 6.1 years). Overall, 40 eyes with PIC-related choroidal neovascular membrane (26%) had final visual acuity less than 6/60. No differences were observed between typical and atypical PIC eyes in any of the outcome measures or in any of the subgroup analyses. Punctate inner choroidopathy-related choroidal neovascularization was not visually benign. No differences were observed between eyes with typical and atypical choroidal lesions, supporting the notion that they represent a spectrum of a single disease, PIC.