Punctate Inner Choroidopathy: A Clinical Case Report
A 29-year-old Caucasian male presented to our emergency department with complaints of decreased central vision in his left eye (LE), detected a few hours before. Ten years before, he had undergone ophthalmic surgery with phakic lens implantation due to high myopia in both eyes. The patient was taking benzodiazepines and beta-blockers due to panic disorder. He denied systemic disease known to be associated with choroiditis, systemic symptoms or recent illness. There was no relevant family history.\nBest-corrected visual acuity (BCVA) in the LE was counting fingers at 50 cm. He described having blurred central vision in the LE tested on the Amsler grid. Fundoscopy of the LE evidenced multiple, round and yellowish lesions in the macula and nasal to the optic nerve, without signs of intraocular inflammation (fig. , left). BCVA in the right eye was 20/20, and ophthalmological examination showed slight changes of the RPE.\nOCT showed increased retinal thickness with detachment of the neuroepithelium and a slight RPE detachment in the LE (fig. , middle). FA revealed hyperfluorescent lesions with blurred borders in the macula (fig. , right).\nWe performed a chest X-ray and an analytic study to exclude autoimmune and infectious diseases. Afterwards an intravitreal injection of bevacizumab (1.25 mg/0.05 ml) was administered in the LE, showing a significant reduction of the neuroepithelial detachment (fig. ). Four months later, BCVA in the LE was 20/200 and no increased retinal thickness was seen on OCT.\nOne year later, the patient was reexamined and showed a BCVA of 20/40 in the LE. FA and OCT appearances confirmed no active lesions, and fundoscopy revealed a chorioretinal scar on papillomacular beam (fig. ). The same findings were also observed 2 years later.