Punctate Inner Choroidopathy with Scars

This patient presented with complaints of seeing dark gray spots in her vision. Her visual acuity was 20/25 in the right eye and 20/32 in the left. Ancillary testing was consistent with punctate inner choroidopathy (PIC). PIC is an inflammatory condition that affects the retina and choroid. It is typically seen in myopic women who are young and healthy. Yellow-white lesions are present in the macula (white arrows) but can exist in the periphery of the retina. In some cases, neovascularization can occur and cause leakage and decreased vision. Fluorescein angiography (FA) revealed she did not have neovascularization but only dry, atrophic scars (blue arrows). Compared to the optical coherence tomography scan of her right eye that showed a regular capillary pattern, the ellipsoid zone and RPE outer reflective lines in her left eye are scarred and irregular. Treatment such as intravitreal injections of anti-VEGF drugs are available for choroidal neovascularization but there are no treatments available for the scars.