A novel view of punctate inner choroidopathy: Characterizing the serial changes by high resolution spectrum-domain optical coherence tomography

We report a case of punctate inner choroidopathy (PIC) treated with oral prednisolone and intravitreous bevacizumab injection (IVB). The case was studied and followed for 5 months by serial spectrum-domain optical coherence tomography (SD-OCT). At the early active phase of PIC, SD-OCT showed dome-shaped retinal pigment epithelium (RPE) elevation with underlying intact Bruch's membrane (BM), overlying photoreceptor inner/outer segment junction (PRJ) disappearance, and homogenous hyperreflective sub-RPE signals. After oral prednisolone and IVB, SD-OCT showed resolution of RPE changes with overlying intact PRJ. Further, the localized outer retinal layers were found to gradually move outward. Our case of PIC was followed by SD-OCT and was successfully treated with oral prednisolone and IVB. SD-OCT may play an important role in early identification of PIC and evaluation of disease progression. According to the serial changes in SD-OCT, we hypothesize that the origin of PIC is most likely to be localized at the RPE level. Early detection and intervention may prevent the progression of PIC to choroidal neovascularization and may lead to good prognosis.
Source: Taiwan Journal of Ophthalmology - Category: Opthalmology Source Type: research