June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Differential Response to Glucocorticoid Immunosuppression of Two Distinct Inflammatory Signs Associated with Punctate Inner Choroidopathy
Author Affiliations & Notes
  • Aliaa Abdelhakim
    Columbia University, New York, New York, United States
    Vitreous Retina Macula Consultants of New York, New York, United States
  • Lawrence A. Yannuzzi
    Vitreous Retina Macula Consultants of New York, New York, United States
  • K Bailey Freund
    Vitreous Retina Macula Consultants of New York, New York, United States
  • Jesse Jeno Jung
    East Bay Retina Consultants, California, United States
  • Footnotes
    Commercial Relationships   Aliaa Abdelhakim, None; Lawrence A. Yannuzzi, None; K Bailey Freund, Bayer (C), Genentech (C), Genentech/ Roche (F), Heidelberg Engineering (C), Novartis (C), Optovue (C), Zeiss (C); Jesse Jung, Alimera (C), Allergan (C), Carl Zeiss Meditec (C)
  • Footnotes
    Support  Heed Ophthalmic Foundation, The Macula Foundation
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 5362. doi:
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      Aliaa Abdelhakim, Lawrence A. Yannuzzi, K Bailey Freund, Jesse Jeno Jung; Differential Response to Glucocorticoid Immunosuppression of Two Distinct Inflammatory Signs Associated with Punctate Inner Choroidopathy. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5362.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To describe the differential response of two distinct inflammatory signs occurring in eyes with punctate inner choroidopathy (PIC).

Methods : A retrospective observational case series utilizing multimodal imaging (MMI) including spectral domain optical coherence tomography (OCT) and fundus autofluorescence (FAF).

Results : We describe 4 eyes of 4 female patients (mean age = 35 +/- 7 years) who presented with acute visual symptoms associated with active findings of PIC. All eyes had 2 distinct signs of active disease: 1) Acute hyperreflective sub-retinal pigment epithelium (RPE) lesions on OCT, and 2) More widespread areas of focal/zonal outer retinal disruption corresponding to both loss of the ellipsoid zone (EZ) and interdigitation zone (IZ) on OCT and to hyperautofluorescence on FAF. All patients were treated with oral prednisone. Following the initiation of treatment, prompt regression of the sub-RPE lesions was accompanied by a concurrent paradoxical centrifugal expansion of outer retinal disruption towards the peripheral retina. The initial expansion of outer retinal disruption was subsequently followed by complete resolution of this finding by 6 weeks in all eyes.

Conclusions : In patients with PIC, two distinct inflammatory signs distinguishable through MMI display a differential response to immunosuppressive therapy with oral prednisone. Whereas inflammatory sub-RPE lesions display a prompt response to oral prednisone, the diffuse transient outer retinal disruption appears to be more resistant to its therapeutic effects. These findings suggest that although these distinct inflammatory signs may coexist in the same eye, they may relate to different cellular and molecular mechanisms, reflect different immunological phenomena, and have independent natural histories.

This is a 2020 ARVO Annual Meeting abstract.

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