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Observational Study
. 2022 Nov 1;42(11):2099-2109.
doi: 10.1097/IAE.0000000000003602.

PUNCTATE INNER CHOROIDOPATHY-LIKE REACTIONS IN UNRELATED RETINAL DISEASES

Maria Vittoria Cicinelli  1   2 , Alessandro Marchese  1   2 , Prithvi Ramtohul  3 , Elisabetta Miserocchi  1   2 , Ugo Introini  1   2 , Francesco Bandello  1   2 , K Bailey Freund  3 , Maurizio Battaglia Parodi  1   2
Affiliations
Observational Study

PUNCTATE INNER CHOROIDOPATHY-LIKE REACTIONS IN UNRELATED RETINAL DISEASES

Maria Vittoria Cicinelli et al. Retina. .

Abstract

Purpose: To report a cohort of patients with a punctate inner choroidopathy (PIC)-like reaction in concurrent, unrelated, chorioretinal disorders.

Methods: This was a retrospective observational study of patients seen at two referral centers with lesions consistent with PIC on multimodal imaging; patients with lesions resembling idiopathic multifocal choroiditis were also included. Active PIC-like lesions appeared as focal hyperreflective lesions splitting the retinal pigment epithelium/Bruch membrane (RPE/BrM) complex on optical coherence tomography. Chronic PIC-like lesions included subretinal fibrosis, multifocal punched-out chorioretinal atrophy, and curvilinear streaks. Patients' demographics, additional imaging features, and treatment responses were collected and summarized.

Results: Twenty-two eyes of 16 patients with a PIC-like reaction were included (75% females; median age 40 years). Underlying diagnoses included hereditary retinal conditions (10 patients, 63%) and acquired etiologies, all characterized by the RPE/BrM or outer retinal disruption. Fifteen eyes (68%) had active PIC-like lesions; seven eyes (32%) had chronic PIC-like lesions. Active PIC-like lesions regressed with time and responded to systemic steroids. Subretinal fibrosis (3 eyes, 20%), macular atrophy (3 eyes, 20%), and concomitant subretinal fibrosis and macular atrophy (5 eyes, 33%) developed on follow-up. Recurrences occurred in five eyes (23%).

Conclusion: RPE/BrM or outer retina disruption may trigger a PIC-like reaction in susceptible patients, presumably because of the loss of immune privilege. A PIC-like reaction may influence the clinical progression and the visual prognosis of the primary chorioretinal disease.

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References

    1. Marsiglia M, Gallego-Pinazo R, Cunha de Souza E, et al. Expanded clinical spectrum of multiple evanescent white dot syndrome with multimodal imaging. Retina 2016;36:64–74.
    1. Spaide RF, Goldberg N, Freund KB. Redefining multifocal choroiditis and panuveitis and punctate inner choroidopathy through multimodal imaging. Retina 2013;33:1315–1324.
    1. Abdelhakim AH, Yannuzzi LA, Freund KB, Jung JJ. Differential response to glucocorticoid immunosuppression of two distinct inflammatory signs associated with punctate inner choroidopathy. Retina 2021;141:812–821.
    1. Bryan RG, Freund KB, Yannuzzi LA, et al. Multiple evanescent white dot syndrome in patients with multifocal choroiditis. Retina 2002;22:317–322.
    1. Jampol LM, Sieving PA, Pugh D, et al. Multiple evanescent white dot syndrome. I. Clinical findings. Arch Ophthalmol 1984;102:671–674.

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