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Stefano Erba, Alba Xhepa, Alessandro Invernizzi, Giovanni Staurenghi; Punctate Inner Choroidopathy: a topographic study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2162.
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© ARVO (1962-2015); The Authors (2016-present)
Most of the inflammatory lesions of punctate inner chroidopathy(PIC) are located at the posterior pole and many cases of PIC are complicated with a choroidal neovascularization(CNV). Because these lesions may lead to severe visual loss if close to the fovea we made a topographic assessment.
Patients with a diagnosis of PIC were retrospectively reviewed. For each visit a SD-OCT volume, fundus autofluorescence(FAF) and FA+ICG when needed were recorded with Heidelberg Spectralis. Location of CNV was classified as subfoveal(SF), iuxtafoveal(IF) or extrafoveal(EF).Then we evaluated the growth of the CNV during the follow up. Furthermore we analyzed the distribution of chorioretinal scars at the posterior pole comparing the FAF at baseline to the FAF of the last visit overlapping the standard ETDRS grid overlay available on the Heidelberg Eye Explorer software.
21 patients(27 eyes), 19 female and 2 male, with a diagnosis of PIC were included. Mean age at presentation was 40,2 years (range 20-75). Mean BCVA at baseline was 0,5 while at the last visit was 0,6. We enrolled patients with average follow up of 40,5 months (range 6-120). 26 eyes (96,2%) were complicated with a CNV. At baseline 11 CNV were SF(42,3%), 7 IF(30,8%) and 8 EF(26,9%). 11 out of 26 CNV enlarged during the follow up and 6 CNV previously located out of fovea became SF. At the last visit 65,4% of CNV were SF while 19,2 % were IF and 15,4% were EF (p=0,045). At baseline 157 out of 243 subfields of ETDRS grid (64,6%) showed the typical chorioretinal scars while at the last visit 200 out of 243 subfields of ETDRS grid were involved (82,3%). At presentation the central and inner nasal subfields were the most frequently involved (81% and 76,9% respectively). All of the central subfields showed a lesion at the last visit. During the follow up the inner and outer temporal subfields showed the highest rates of new lesions (23,1% and 26,9% respectively) while the outer inferior sector was the less commonly affected at baseline as well as at the last visit.
In our case series nearly half of the CNV involved the fovea at baseline and some of the other CNV (iuxtafoveal and extrafoveal) grew towards the fovea during the follow up. Moreover the typical atrophic scars at the posterior pole tended to enlarge with time and also increase in number involving previously disease free regions of the macula, in particular expanding to the temporal side.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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