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CASE REPORT
Year : 2014  |  Volume : 4  |  Issue : 4  |  Page : 179-183

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


1 Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
2 Department of Ophthalmology, Taipei Veterans General Hospital; Department of Ophthalmology, National Yang-Ming University School of Medicine, Taipei, Taiwan
3 Department of Ophthalmology, Taipei Veterans General Hospital; Department of Ophthalmology, National Yang-Ming University School of Medicine; Department of Ophthalmology, Taipei Medical University, Taipei, Taiwan

Correspondence Address:
Chang-Sue Yang
Department of Ophthalmology, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.1016/j.tjo.2013.10.006

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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 neo-vascularization and may lead to good prognosis.


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