Niederer RL, et al. - Herein, individuals with punctate inner choroidopathy (PIC) were inspected, in order to gauge the risk factors for the development of choroidal neovascular membrane (CNVM) and visual loss. It was deduced that visual loss was a common occurrence in patients with PIC, predominantly secondary to the late development of CNVM. It was suggested that oral corticosteroid therapy could reduce the risk of CNVM development. Additionally, anti-VEGF therapy for CNVM correlated with better clinical outcomes.

Methods

• The plot of this research was a retrospective case series.
• The enrollment comprised of 203 candidates (318 eyes) with PIC, from the Moorfields Eye Hospital between 1996 and 2016.
• Data extraction took place from the clinical notes of all subjects identified with PIC.
• Development of CNVM, moderate visual loss (MVL) (≤20/50), and severe visual loss (SVL) (≤20/200) were the main outcome measure.

Results

• The enrollees were predominantly young (median age at presentation, 32.9 years; interquartile range [IQR], 26.1-42.2), myopic (91.5%), female (87.2%), and white (75.9%).
• Bilateral presentation was noted of the disease in 115 subjects (56.7%), and CNVM was present at the presentation in 152 eyes (47.8%).
• 8.4 years was found to be the median follow-up.
• The occurrence of new CNVM was noted in 58 eyes (33.5% of affected eyes and 4.3% of initially unaffected eyes).
• A relationship was disclosed between the increased risk of developing CNVM with the presence of a CNVM in the fellow eye (P < 0.0005; hazard ratio [HR], 2.73), and previous oral corticosteroid treatment was connected to halving of the risk of developing CNVM (P = 0.035; HR, 0.45).
• There was no variation in the visual outcome with oral corticosteroids.
• However, individuals treated with anti-VEGF displayed better visual outcomes (12-month median visual acuity, logarithm of the minimum angle of resolution [logMAR] 0.00 with anti-VEGF and 0.20 without; P = 0.018).
• Median best-corrected visual acuity (BCVA) was 20/30 at presentation (IQR, 0.00–0.50) and persisted at 20/30 during the course of all follow-up periods.
• Moderate visual loss was found in 40 eyes (12.6%), with an incidence of 0.01 per eye-year, and there was an occurrence of SVL in 49 eyes (15.4%), with an incidence of 0.01 per eye-year.
• Female enrollees were half as likely as male participants to develop MVL (P = 0.030; HR, 0.448).
• Individuals with CNVM illustrated a greater risk of MVL (P = 0.003; HR, 21.074).