Abstract
Purpose :
To report clinical characteristics, treatment outcomes, and rate of choroidal neovascularization (CNV) in patients with punctate inner choroiditis (PIC) and idiopathic multifocal choroiditis (MFC).
Methods :
A retrospective chart review of patients diagnosed with PIC and MFC at Illinois Eye and Ear Infirmary from January 2015 to September 2023 was performed. Demographic data, clinical features, including the presence of CNV, and treatments were collected. Main outcome measures, including best corrected visual acuity (BCVA) and rate of CNV, were analyzed.
Results :
Thirty-five eyes of 23 patients were included: 17 eyes (12 patients) with PIC and 18 eyes (11 patients) with MFC. Nineteen patients (82.6%) were female with an average age of 35.6 years (range: 14-65 years). Most patients were of Hispanic ethnicity (15; 65%). Myopia was presented in 29 (82.9%) of all eyes. The mean follow-up period was 40.8 months (range: 3.5-104 months). Treatments included oral prednisone in 13 patients (56.5%) and periocular corticosteroid injections in 3 eyes. Twelve patients (52.2%) received steroid-sparing immunomodulatory therapy (IMT), including methotrexate (6), mycophenolate mofetil (7), adalimumab (5), and secukinumab (1) for a mean duration of 18.5 months. CNV was present in 10 eyes (28.6%) at presentation and developed in 2 additional eyes (1 PIC, 1 MFC) during months 3 and 20 of study follow-up, for a total of 12 eyes (34.3%). CNV was foveal in 8 eyes (66.7%) and extrafoveal in 4 eyes (33.3%). Eight of these eyes had active CNV. Three eyes received anti-vascular endothelial growth factor (anti-VEGF) alone, 2 eyes received systemic steroids and IMT, and 3 eyes received combined anti-VEGF, systemic steroids, and IMT. The mean number of anti-VEGF injections was 5.5 (range: 2-15). CNV developed in 43.5% of Hispanic patients (10 of 23 eyes) and 20% of non-Hispanic patients (2 of 10 eyes). Twenty-three eyes (65.7%) with PIC/MFC maintained BCVA of 20/40 or better, and 11 eyes (31.4%) had BCVA 20/50 to 20/200. Causes of vision loss were subfoveal CNV and chorioretinal scarring involving the fovea.
Conclusions :
Approximately one-third of patients with PIC/MFC had CNV, with over 25% having CNV at presentation. Patients with Hispanic ethnicity had rates of CNV twice that of non-Hispanics. Most patients with PIC/MFC showed favorable visual outcomes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.