• Written By: J. Fernando Arevalo, MD, FACS

    The authors of this retrospective study describe the clinical course of all patients diagnosed with punctate inner choroidopathy (PIC) at their institution over a 10-year period. While they found a relatively high rate of CNV development (75 percent) and recurrence (42 percent), they also found that aggressive treatment with immunosuppressive therapy provided good visual results after three years.

    There were 12 patients diagnosed with PIC. Their average age at presentation was 32 years (range, 24 to 52 years). Eleven were women, and 11 were white. Ten of the 11 patients with available refractive data were myopic. Treatment ranged from oral immunosuppression to intravitreal injection.

    Eight of the 12 patients diagnosed with PIC had CNV at initial presentation and one later developed CNV. Of the eight patients with an average follow-up of four years, five had CNV at initial presentation and five developed new CNV. More than 30 percent of patients had multiple CNV membranes.  

    All six patients with a follow-up of at least three years had visual acuity at three years post-presentation of better than 20/40 in at least one eye, and four had visual acuity better than 20/40 bilaterally.

    The authors say the high rate of CNV occurrence in this study, which is at the upper end of the reported spectrum of 27 percent to 77 percent, may be due to the relatively extended follow up. They could not comment on the efficacy of specific treatment options since few patients received each type of treatment. It is also notable that these patients were referrals to a tertiary center. Thus, asymptomatic patients with PIC likely exist, and the reported 75 percent incidence rate of CNV may not apply to the real world.