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Punctate inner choroidopathy is an idiopathic inflammatory ocular disorder characteristically seen in young myopic women. Visual prognosis is generally good but sight threatening choroidal neovascularisation may develop in up to 40% patients.1 We discuss verteporfin photodynamic therapy in subfoveal choroidal neovascularisation secondary to punctate inner choroidopathy that failed to respond to oral corticosteroids and had poor results with submacular surgery in the contralateral eye.
Case report
A 40 year old white female patient with punctate inner choroidopathy was referred to our macular clinic with rapidly deteriorating vision in her left eye secondary to a subfoveal choroidal neovascularisation. She had a history of poor vision in the right eye following submacular surgery to remove a subfoveal choroidal neovascular membrane. Best corrected vision was hand movements in the right eye and 6/18 in the left eye. The logMAR acuity in the left eye was 0.46 (38 letters misread). The anterior segments and intraocular pressures were normal. Both fundi showed characteristic multiple pigmented atrophic scars in the posterior pole and mid-periphery in the absence of vitreous cells. There was a macular scar in the right eye (Fig 1). In the left eye there was an elevated grey lesion with subretinal fluid and intraretinal haemorrhages (Fig 2A). Fluorescein angiography confirmed a predominantly classic subfoveal choroidal neovascular membrane (Fig 2B and C). Argon …