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J.G. Wong, R.W. Essex, A. Tufail, A.C. Bird, J.G. Dowler; Punctate Inner Choroidopathy and Choroidal Neovascularization – Treatment Outcomes . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2153.
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Optimal treatment for choroidal neovascularisation secondary to punctate inner choroidopathy remains controversial. We describe the treatment outcomes of 74 eyes of 60 patients with punctate inner choroidopathy (PIC) and secondary subretinal neovascularization.
We conducted a retrospective analysis of the clinical histories of 60 patients who presented to Moorfields Eye Hospital with a diagnosis of choroidal neovascularization secondary to PIC.
A predominantly younger, myopic female population consisting of 74 eyes of 60 patients had treatment for secondary choroidal neovascularization associated with PIC. Lesion composition included subfoveal and extrafoveal choroidal neovascular membranes. Nineteen eyes of 74 (25%) were treated with systemic or periocular steroids alone, argon laser photocoagulation alone was used in 17 eyes (23%), 3 eyes (4%) had both systemic steroids and argon laser photocoagulation, submacular surgery alone was used to treat 6 eyes (8%), combination submacular surgery and steroids used in 6 eyes (8%), surgery and argon laser photocoagulation in 1 case (1%) and surgery, argon laser and steroids in 1 case (1%). Verteporfin photodynamic therapy (PDT) only was used to treat 6 eyes (8%) and combination PDT and steroids (systemic, periocular or intraocular injection) were used to treat 8 eyes (20%). Median visual acuity of all patients at presentation was 6/24 (HM–6/6), with median worst visual acuity recorded at 6/60 (HM–6/6). Patients treated with combination photodynamic therapy and steroids and those treated with submacular surgery had a trend towards better vision than those in other treatment groups.
Although lesion composition varied across treatment groups, patients with choroidal neovascularization from PIC who had treatment with PDT and steroids or submacular surgery appeared to have benefit compared with other treatment modalities. Further prospective investigations and comparison with natural history studies are necessary to determine treatment efficacy.
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