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K. H. Patel, A. D. Birnbaum, H. H. Tessler, D. A. Goldstein; Presentation and Outcome of Patients With Punctate Inner Choroidopathy (PIC) at a Tertiary Referral Center. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5874.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the clinical course of patients with punctate inner choroidopathy (PIC) seen at the University of Illinois Department of Ophthalmology, with emphasis on incidence and recurrence of choroidal neovascular membranes (CNV).
Patients with a diagnosis of PIC were identified retrospectively. The diagnosis of PIC was made clinically based on findings of multiple, small "punched-out" lesions in the posterior pole, in the absence of intraocular inflammation. The presence of "histo spots" in the periphery was an exclusion criterion. All patients underwent testing to exclude syphilis and sarcoidosis. Medical records were evaluated for clinical evidence of CNV confirmed by fluorescein angiography.
Twelve patients with a diagnosis of PIC between 1997 and 2007 had available medical records. Average age at presentation was 32 years (range 24-52). Eleven patients were female; 11 were Caucasian. Refractive data was available on 11 patients; 10 had greater than -1.00 D myopia. Eight (67%) had CNV at initial presentation, and 1 later developed CNV. CNV, whether present as inactive CNV on the initial visit or as recurrent CNV, was bilateral in 4 patients. Eight patients had follow-up examination, with the average length of follow-up of 50 months (17 - 118). Of the 8 patients with clinical follow-up, 5 had CNV at initial presentation, and 5 experienced recurrences. The average time from presentation to recurrence of CNV was 9 months. One patient had only one recurrence, while 4 had multiple recurrences. Recurrent CNV was bilateral in 4 patients. Treatment modalities varied. All 8 patients who maintained clinical follow up had visual acuity (VA) 3-years post presentation > 20/40 in at least one eye. Six had VA > 20/40 in both eyes.
Seventy-five percent of PIC patients in this series developed CNV, and more than 30% developed multiple recurrences of CNV. Despite this, the use of immunosuppressive therapy and aggressive treatment of CNV was associated with the maintenance of > 20/40 vision in at least one eye of all patients with available follow-up.
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