Article

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: 3.18). 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.

0 Followers
 · 
97 Views
  • [Show abstract] [Hide abstract]
    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 · 3.18 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: PURPOSE: To describe the natural course of punctate inner choroidopathy (PIC) using spectral-domain optical coherence tomography (SD-OCT). DESIGN: Prospective observational case series. PARTICIPANTS: Forty-two consecutive patients (60 eyes) with PIC with at least 3 months of follow-up. METHODS: Serial SD-OCT images were obtained from both eyes of each participant at each visit. MAIN OUTCOME MEASURES: The morphologic characteristics of each stage of PIC lesions observed by SD-OCT. RESULTS: Continued stage progression of PIC lesions was observed in 27 eyes (45%), among which choroidal thickness changes were observed in 8 eyes (30%). Stage I lesion showed a normal appearance or slight irregularities in the outer nuclear layer. Stage II lesion appeared as a focal elevation of the retinal pigment epithelium (RPE) with corresponding disruption of the inner and outer segments of the photoreceptor interface. Stage III lesion broke through the RPE, forming a hump-shaped chorioretinal nodule with moderate reflectivity beneath the outer plexiform layer (OPL), generally with subsequent disruption of Bruch's membrane. Nodules occasionally invaded the inner retina, causing segmental retinal phlebitis in 2 eyes. Stage IV lesion regressed in a retrograde manner with tissue loss from the photoreceptor layer and inner choroid, finally leaving a V-shaped hernia of the OPL and inner retina into the choroid. Stage V lesion gradually eliminated the photoreceptors around the lesion; this process was accompanied by RPE proliferation at multiple levels, which reduced retinal herniation. Parafoveal stage V lesions caused late occult macular atrophy in 4 eyes. Choroidal thickness increased throughout the active phase and reached a peak at stage III; this parameter then significantly decreased at stage IV and gradually reached a minimum that was lower than the initial value at stage I. CONCLUSIONS: Punctate inner choroidopathy is a chorioretinitis rather than an inner choroidopathy. Spectral-domain OCT characterized a 5-stage evolution of PIC lesions: choroidal infiltration, formation of sub-RPE nodules, and then chorioretinal nodules, regression, and retinal herniation. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
    Ophthalmology 06/2013; 120(12). DOI:10.1016/j.ophtha.2013.05.012 · 6.17 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    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 · 1.94 Impact Factor
Show more