Prevalence and Characteristics of Multifocal Choroiditis/Punctate Inner Choroidopathy in Pathologic Myopia Eyes With Patchy Atrophy

Hady, Shymaa K.; Xie, Shiqi; Freund, K. Bailey; Cunningham, Emmett T.; Wong, Chee Wai; Cheung, Chui Ming Gemmy; Kamoi, Koju; Igarashi, Tae; Ali, Omar Mohammed; Wasfi, Ehab; Rateb, Mahmoud; Ohno‐Matsui, Kyoko

doi:10.1097/iae.0000000000003383

Cited by 13 publications

(21 citation statements)

References 30 publications

(65 reference statements)

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“…9,12 White dot syndromes with PIC-like features have been well described in eyes with PM. 7 Our cases are examples of WDS with PIC-like features in eyes with extensive outer retinal disruption because of inherited or acquired conditions other than PM. We suggest that PIC-like reactions may develop in these eyes with preexistent outer retinal disruption resulting in loss of the immune privilege.…”

Section: Discussionmentioning

confidence: 77%

“…12 Parallelly, PIC is clinically associated with pathologic myopia (PM). 7,13 As PIC lesions tend to cluster around sites of pre-existent retinal pigment epithelium/Bruch membrane (RPE/BrM) complex damage (e.g., lacquer cracks) in eyes with PM, a causative relationship between local inflammation and mechanical insults to RPE/BrM has been postulated. 7,13 In this study, we collected a series of patients with features of PIC on MMI in the setting of apparently unrelated posterior segment diseases, assuming that the PIC lesions were not incidental but related to the underlying condition.…”

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confidence: 99%

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confidence: 99%

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Punctate Inner Choroidopathy–like Reactions in Unrelated Retinal Diseases

Cicinelli

Marchese

Ramtohul

et al. 2022

Retina

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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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Section: Discussionmentioning

confidence: 77%

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confidence: 99%

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Punctate Inner Choroidopathy–like Reactions in Unrelated Retinal Diseases

Cicinelli

Marchese

Ramtohul

et al. 2022

Retina

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“…We agree with the authors that concurrent findings of pathologic myopia and idiopathic PIC/iMFC are relatively common and patchy chorioretinal atrophy due to PIC/iMFC can be difficult to distinguish from those secondary to pathologic myopia. 5 Considering the frequency of the association of PIC/iMFC with pathologic myopia, we cannot unquestionably exclude that a PIC/iMFC component is absent.…”

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Amoroso

Mière

Cohen

et al. 2023

Retina

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“…[6][7][8][9][10] Likewise, atrophic foci of idiopathic MFC have been shown to grow despite administration of systemic treatment aimed at preventing uveitis reactivation. Although relapses of the disease lead to the formation of new lesions eventually evolving to scars, with an overall increase in total macular atrophic area, 5,[11][12][13][14][15] there is a lack of knowledge on the effect of inflammatory reactivations on the rate of expansion of already established atrophic lesions.…”

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confidence: 99%