_inner choroidopathy extras点状内层脉络膜病变演员课件

Punctate Inner Choroidopathy Ahmed Magdy Bedda, MD, PhD Professor of Ophthalmology Rowayda M. Amin, MSc Assistant lecturer of Ophthalmology Alexandria University Ocular History n25 year old female presented with recent diminution of vision in her OD ngradual progressive loss of vision in her OS over the previous 1.5 years nno steroid or immunomodulatory therapy First presentation n n OD:OD: n n BCVA 6/12BCVA 6/12 n n anterior anterior segment wassegment was unremarkableunremarkable n n trace vitreous celltrace vitreous cell n n Fundus: Fundus: n n smallsmall, white-yellow lesions at the level of , white-yellow lesions at the level of the choroid and the choroid and RPE that RPE that surround the disc surround the disc and the macular and the macular regionregion First Presentation n n OS:OS: n n BCVA 1/60BCVA 1/60 n n Anterior segment Anterior segment unremarkableunremarkable n n no vitreous cellno vitreous cell n n Fundus: Fundus: n n multiple smallmultiple small, white-yellow , white-yellow punched out punched out lesions that lesions that surround the surround the disc with older disc with older pigmented lesions involving the maculapigmented lesions involving the macula Investigations nFA: Early hyperfluorescence with late staining and leakage of the macular lesions Investigations nFA: Early hyperfluorescence with late staining and leakage of the macular lesions Treatment noral prednisone n60 mg daily for two weeks nfollowed by weekly 10 mg taper down to 20 mg nthen 5 mg biweekly taper over another 4 weeks nAzathioprine 50mg bid 6 Weeks after Treatment nOD: nBCVA 6/9 nFundus lesions have scarred and are more well-defined with a discrete border. 6 Weeks after Treatment nOS: nBCVA: 6/9 nFundus lesions have more well-defined edges and a punched-out appearance with some more pigmentation. Conclusion nPIC is an idiopathic disorder within the spectrum of multifocal choroiditides ntypically it is not associated with intraocular inflam