PMC3136150_01
Right and left fundus photos of patient with recurrent punctate inner choroidopathy. Right fundus shows multiple yellowish-white chorioretinal lesions, some appear atrophic, localized to the posterior pole. Just inferior to the fovea is a pigmented scar from a successfully treated choroidal neovascular membrane. The left fundus shows a new focal yellowish chorioretinal lesion with surrounding fluid not documented on previous fundus photographs.
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fig1
Funduscopy showed multiple yellowish-white chorioretinal lesions and a pigmented scar from the CNVM localized within the posterior pole in the right eye, and a focal chorioretinal lesion with fluid just nasal to the fovea in her left eye (Figure 1).
Spectralis spectral-domain optical coherence tomography (SD-OCT) images taken at the same location of both eyes over a 5.5-month period in a patient with recurrent punctate inner choroidopathy. (a) and (b) Initial visit. (b) Shows outer retinal irregularity and inner retinal fluid (IRF) from choroidal neovascular membrane (CNVM). (c) and (d) Followup two weeks later. After intravitreal bevacizumab treatment, left eye, shows resolution of IRF (d). (e) and (f) Two months later shortly after stopping chronic antiviral therapy. The patient experienced new photopsias, right eye, and SD-OCT revealed homogenous outer retinal thickening over chorioretinal lesions consistent with recurrent inflammatory activity (e). (g) and (h) Three months later after treatment. Symptoms subsided, and outer retinal thickening has resolved (g). Left eye shows no reoccurrence of CNVM (h).
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fig2
Spectralis spectral-domain optical coherence tomography (SD-OCT) (Spectralis HRA; Heldelberg Engineering, Heidelberg, Germany) of the left eye at the initial visit showed retinal pigment epithelium (RPE) elevation with surrounding intraretinal fluid (IRF) consistent with CNVM (Figure 2(b)). Two weeks after treatment with intravitreal bevacizumab, SD-OCT showed resolution of IRF (Figure 2(d)). SD-OCT was suggestive of recurrent inflammatory lesion activity with new homogeneous outer retinal thickening overlying chorioretinal lesions but with no IRF (Figure 2(e)).