Clinical features of punctate inner choroidopathy in Chinese patients

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Retina (Philadelphia, Pa.) (Impact Factor: 3.24). 04/2011; 31(8):1680-91. DOI: 10.1097/IAE.0b013e31820a67ad
Source: PubMed

ABSTRACT To characterize the clinical features of punctate inner choroidopathy (PIC) in Chinese patients.
A retrospective chart review of all patients admitted with PIC from June 1999 to October 2009.
Of the 75 patients (112 eyes) diagnosed with PIC, 72% were women, 80% were myopic, and 49% exhibited bilateral involvement. The mean age at presentation was 32 years. Blurred central vision (64%) and scotoma (40%) were the most common symptoms. Multifocal PIC lesions were mostly restricted to the posterior pole (95%). The acute lesions were yellow and demonstrated hyperfluorescence (61%) or mild hyperfluorescence (36%) on fluorescein angiography, mostly (75%) <200 μm in diameter and <10 in number. Indocyanine angiography showed subclinical hypofluorescent spots in 32% of the affected eyes. Choroidal neovascularization developed in 63% of affected eyes. Papilledema (3%) and segmental retinal phlebitis (2%) were rare. Intact follow-up data of 27 patients (43 eyes) were available. Acute lesions turned into punched-out atrophic lesions within 3 months. New visible lesions developed in 5 eyes within 1 year after symptom onset. New choroidal neovascularization developed in five eyes. The mean best-corrected visual acuity significantly improved at last follow-up (P = 0.039).
Punctate inner choroidopathy in Chinese is not rare and primarily affects young myopic women. It features multifocal, small, yellow lesions that develop within a short period, principally in the posterior pole, with subsequent atrophy. Complicated choroidal neovascularization is frequent. General visual prognosis is moderately good.

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    • "The pathogenesis of PIC is still largely unresolved. Indocyanine green angiography (ICGA) images obtained during the initial phase show hypofluorescence corresponding to the PIC lesions, suggesting inflammation-related choroidal circulation impairment [4,5]. The details of changes in choroidal circulation hemodynamics during the course of the disease remain unknown. "
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    ABSTRACT: Background Changes in choroidal circulation hemodynamics during the course of punctate inner choroidopathy (PIC) remain unknown. The aim of this study was to quantitatively evaluate changes in choroidal blood flow velocity by using laser speckle flowgraphy (LSFG) in patients with PIC. Case presentation This PIC patient was initially treated with systemic corticosteroids for 4 months. LSFG measurements were taken 10 consecutive times before treatment and at 1, 3, 12, 20 and 23 months after the initiation of therapy. The mean blur rate (MBR), a quantitative index of relative blood flow velocity, was calculated using LSFG in three regions: Circles 1, 2 and 3 were set at the fovea, a lesion site, and an area of normal-appearing retina, respectively. The PIC lesions scarred after treatment along with improvements in visual function and outer retinal morphology. When the changing rate of macular flow over the 12-month follow-up period was compared with the MBR before treatment (100%), an increase of 16–37%, 24–49% and 15–18% was detected in Circles 1, 2 and 3, respectively. At the time of PIC recurrence after 20 months, the MBR decreased temporarily but subsequently increased after retreatment with systemic corticosteroids. This trend was accompanied by a decrease in choroidal thickness at the lesion site after retreatment. Conclusions Macular choroidal blood flow velocity increased and choroidal thickness decreased concurrently with regression of PIC. The present findings suggest that inflammation-related impairments in choroidal circulation may relate to the pathogenesis of PIC, extending over a wider area in the posterior pole than the PIC lesions per se.
    BMC Ophthalmology 05/2014; 14(1):73. DOI:10.1186/1471-2415-14-73 · 1.02 Impact Factor
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    • "Though some of the above white dot syndromes have differences in the ratios of involvement of men to women, no clinical differences have been described between the sexes [1–3, 5, 8–15, 17–20, 24, 26–29, 31–33, 37, 38, 44–47, 50–52, 54–59, 61, 62, 65, 68–71]. In review of the reports, no distinctions were made between the genders in age of onset, initial clinical findings, or severity of disease. "
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    ABSTRACT: Inflammatory conditions that affect the posterior pole are diverse. Specifically, birdshot chorioretinopathy and the white dot syndromes present with multiple white dots in the fundus. These diseases appear to affect similar age groups but there is question as to whether or not a difference exists between the genders. This review summarizes the current studies on birdshot chorioretinopathy and the white dot syndromes as they are related to gender, exploring the differences, if any, which may exist between prevalence, clinical presentation, and treatment response for these diseases. Though the specific etiology of these diseases remains unclear, future treatments may be guided as to how these diseases affect the sexes differently.
    Journal of Ophthalmology 02/2014; 2014:146768. DOI:10.1155/2014/146768 · 1.43 Impact Factor
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    ABSTRACT: To evaluate the efficacy and safety of intravitreal bevacizumab as primary treatment of choroidal neovascularization secondary to punctate inner choroidopathy. Twelve eyes of 12 patients with subfoveal or juxtafoveal choroidal neovascularization secondary to punctate inner choroidopathy received intravitreal bevacizumab injection (1.25 mg) in this prospective case series. Injection was repeated if persistent or recurrent activity of choroidal neovascularization was indicated by optical coherence tomography or fundus fluorescein angiography at 1-month intervals. Visual, clinical, angiographic, and anatomical changes were observed over a 12-month follow-up period. After 12 months of follow-up, mean logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.49 (20/62 in Snellen equivalent) at baseline to 0.23 (20/34 in Snellen equivalent; P < 0.001). Mean central retinal thickness determined by optical coherence tomography decreased from 333 μm to 241 μm (P < 0.001). All eyes (100%) had stable or improved vision, and 9 eyes (75%) showed an improvement of ≥ 2 lines. All lesions converted to the cicatricial phase after 12 months of follow-up. No drug-related systemic or ocular side effects were observed. Intravitreal bevacizumab is well tolerated and improves best-corrected visual acuity in choroidal neovascularization secondary to punctate inner choroidopathy over a 12-month period.
    Retina (Philadelphia, Pa.) 04/2012; 32(6):1106-13. DOI:10.1097/IAE.0b013e318242b9da · 3.24 Impact Factor
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