Punctate Inner Choroidopathy Research Articles

Photodynamic Therapy for Subfoveal and Juxtafoveal Choroidal Neovascularization Associated with Punctate Inner Choroidopathy

Purpose: To evaluate the treatment of subfoveal and juxtafoveal choroidal neovascularization (CNV) using verteporfin photodynamic therapy (vPDT) in patients affected by punctate inner choroidopathy (PIC). Methods: A chart review of 8 patients with CNV associated with PIC treated with vPDT was done. Results: The 8 patients (8 eyes) included 4 men and 4 women with a mean age of 30.9 years. Six of them presented juxtafoveal CNVs, and two had subfoveal CNVs, at presentation. Mean follow-up time was 22.7 months. The VA improved in five eyes, and three eyes declined. One patient developed a new CNV a few days after vPDT, and one had multiple CNVs at presentation. Two of the 3 patients with longer follow-up period presented late recurrences. Conclusions: vPDT is a beneficial resource in stabilizing and also improving VA in PIC patients affected with subfoveal and juxtafoveal CNV, although one third of the patients retain poor visual acuity.

Punctate inner choroidopathy: resolution after oral steroid treatment and review of the literature

Case report: A case of punctate inner choroidopathy (PIC) that resolved after oral steroid treatment is described. The 25-year-old female patient presented with reduced visual acuity of several days duration. Results of fundus examination, fluorescein angiography, and indocyanine green angiography were consistent with PIC with a small choroidal neovascularization lesion nasal to the fovea. Visual acuity improved significantly after several days on oral steroid treatment. Comments: Although spontaneous resolution of the lesions can occur without any treatment, oral steroids in PIC may help achieve improved vision more rapidly. The clinical manifestations, differential diagnosis, and therapeutic modalities of this rare entity are discussed.

Photodynamic Therapy for Subfoveal Classic Choroidal Neovascularization Related to Punctate Inner Choroidopathy (PIC) or Presumed Ocular Histoplasmosis-Like Syndrome (POHS-Like)

Purpose: To evaluate the safety and efficacy of photodynamic therapy with verteporfin (PDT) for subfoveal classic choroidal neovascularization (CNV) related to punctate inner choroidopathy (PIC) or presumed ocular histoplasmosis-like syndrome (POHS-like). Methods: Retrospective review of 16 eyes from 14 patients with subfoveal classic CNV associated with PIC or POHS-like and treated with PDT. Results: The mean visual acuity increased from 4.5/10 (range: 1/10–9/10) to 7/10 (range: 2/10-10/10) after a mean follow-up of 21 months (range: 8–32 months) and a mean number of 2 PDT (range: 1–6). Visual acuity remained stable or improved in 13 of the 16 eyes (81%) and decreased in three. Conclusion: This nearly two-year follow-up study suggests that PDT could be helpful for patients with subfoveal classic CNV related to PIC or POHS-like.

Long-term results after photodynamic therapy with verteporfin for choroidal neovascularizations secondary to inflammatory chorioretinal diseases.

To evaluate the safety and the long-term effect on visual acuity of photodynamic therapy (PDT) for sub- and juxtafoveal choroidal neovascularizations (CNV) secondary to inflammatory conditions. In a prospective pilot study, 19 patients with CNV due to inflammatory conditions underwent PDT treatment with verteporfin with standard parameters. Regular follow-up was carried out every 3 months with ETDRS visual acuity measurement and fluorescein angiography. The initial diagnosis included punctate inner choroidopathy (PIC) ( n=7), presumed ocular histoplasmosis syndrome (POHS) (6), multifocal choroiditis with panuveitis (MCP) (2) and other inflammatory conditions (4). All patients had a minimum follow-up of one year. After a mean follow-up of 22.1 months, the mean change in visual acuity was +1.63 ETDRS lines. At their last visit, all eyes showed a disappearance of pretreatment leakage in fluorescein angiography and 63.2% (12/19) eyes had an improvement of 2 or more lines, while 26.3% (5/19) remained stable (+/-1 line) and 10.5% (2/19) lost 2 or more lines. A mean of 2.0 (1-5) treatments was performed. No clinically relevant side effects or complications were observed. PDT is a safe and effective treatment option for CNV secondary to inflammatory conditions. The results are better than for CNV secondary to AMD. For juxtafoveal CNV, the results are similar to those of subfoveal CNV with no additional safety concerns. Based on this observation, we consider PDT as treatment of choice for subfoveal CNV secondary to inflammatory chorioretinal diseases and for selected cases with juxtafoveal CNV.

Functional assessment of the native retinal pigment epithelium after the surgical excision of subfoveal choroidal neovascular membranes type II: preliminary results.

Subretinal neovascular membranes (CNV) can occur in a variety of conditions. SRNVM most commonly occur in age-related macular degeneration (AMD), punctate inner choroidopathy (PIC)/multifocal inner choroidopathy (MIC) and myopia. AMD and CNV most common cause of blindness in western world.

Visual Prognosis of Multifocal Choroiditis, Punctate Inner Choroidopathy, and the Diffuse Subretinal Fibrosis Syndrome

To characterize the visual prognosis of patients with multifocal choroiditis and panuveitis (MCP), punctate inner choroidopathy (PIC), and the diffuse subretinal fibrosis (DSF) syndrome. Forty-one patients with MCP, 16 with PIC, and 5 with DSF syndrome were evaluated. The mean follow-up was approximately 39 months for patients with MCP, 51 months for patients with PIC, and 59 months for patients with DSF syndrome. Complete ophthalmic examinations were performed, and photofiles were reviewed. The final average visual acuity for patients with MCP was 20/50. Forty-five of the 68 involved eyes (66%) had 20/40 visual acuity or better. Choroidal neovascularization (CNV) developed within choroiditis lesions in 22 (19 patients) of 68 eyes, causing visual acuity poorer than 20/50 in 14 eyes. The final average visual acuity in patients with PIC was 20/39; 23 (77%) of the 30 involved eyes had visual acuity of 20/40 or better. Six of the seven eyes with 20/50 or poorer vision had CNV. Six other eyes had CNV within the macula that regressed spontaneously with good resultant vision. Seven of the ten involved eyes with DSF syndrome had 20/200 or poorer vision. Poor vision was due to fibrosis and atrophy within the macula. Most patients with MCP and PIC retained visual acuity of 20/40 or better. In nearly one third of patients with MCP and PIC, CNV developed. Severe visual loss in these diseases was usually due to subfoveal CNV. Patients with DSF syndrome had a poor prognosis due to fibrosis and atrophy involving the macula.

Enlarged Blind Spots in Chonoretinal Inflammatory Disorders

This study was undertaken to better characterize patients with multifocal choroiditis and panuveitis (MCP), punctate inner choroidopathy (PIC), multiple evanescent white dot syndrome (MEWDS), and diffuse subretinal fibrosis syndrome. The specific aim was to determine whether these disorders were different entities or part of a spectrum of diseases with similar features. Seventy-nine patients were included in this study. Most of the patients have been followed up prospectively since July 1980 with some found retrospectively. Forty-one patients had MCP, 16 had PIC, 6 had diffuse subretinal fibrosis syndrome, and 16 had MEWDS. Patients with MCP had visual loss and visual field defects caused directly by visible lesions or recurrent inflammation around old lesions. In particular, clustering of lesions around the optic nerve and nasal periphery was seen in patients with MCP and appeared to be related to visual field loss. Patients with PIC also had enlarged blind spot and other field defects explained by fundus lesions. Patients with PIC and MCP did not have recurrent lesions on extended follow-up. Patients with diffuse subretinal fibrosis syndrome represented a subset of patients characterized with lesions in the posterior pole, sever scarring, and visual loss. Patients with MEWDS had the least inflammation with symmetrically distributed lesions. Minimal permanent chorioretinal scarring was seen in patients with MEWDS. Visual field defects improved in most patients with MEWDS and PIC, whereas most patients with MCP and diffuse subretinal fibrosis syndrome did not improve. Although enlarged blind spots are a feature of all four disorders, other clinical, angiographic, and electroretinographic evidence suggest that these are different entities.