Case 49
History: A 43 year-old myopic woman was referred by her optician because of reduced right vision
and multiple atrophic scars in the macula. Her previous retina examination 2 years ago was 
normal. The vision was 6/24 in the right eye and 6/9 in the left eye. There was no vitritis. The 
appearance is suggestive of the condition punctate inner choroidopathy (PIC). 
This condition is characterized by:
- moderate myopia 
- female sex 
- multiple, yellow-white lesions of the inner choroid and retina confined to the posterior
   pole, and that after resolution leave atrophic pigmented scars
  • - frequent serous detachment of the retina that resolves spontaneously
  • - absence of vitritis or anterior uveitis
  • - bilateral ocular involvement common
  • - negative histoplasmin skin test (70%)
  • - choroidal neovascularization in 40% of eyes
  • - relatively good visual prognosis with 50% retaining normal acuity
  • The vision remained unchanged in her right eye in subsequent follow-up and no signs of subretinal
  • neovascular membrane. In one of the visits she was noted to have a blot haemorrhage in
  • her left eye but her blood pressure and blood tests including glucose were normal and the
  • intraocular pressures in both eyes were normal. The haemorrhage resolved spontaneously.

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