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Leung, Theresa G. MD*; Moradi, Ahmadreza MD*; Liu, Dianna MD*; Nguyen, Quan D. MD†,‡; Dunn, James P. MD*; Burkholder, Bryn MD*; Butler, Nicholas J. MD*; Ostheimer, Trucian MD*; Thorne, Jennifer E. MD, PhD*,§

doi: 10.1097/IAE.0000000000000125
Original Study

Purpose: To study the clinical features and incidence rate of ocular complications in patients with punctate inner choroidopathy.

Methods: This is a retrospective cohort study conducted in a single-center academic practice setting. Patients diagnosed with punctate inner choroidopathy at the Wilmer Eye Institute, Johns Hopkins University from 1984 to 2012 were identified. Demographics and clinical features including the presence of choroidal neovascularization (CNV) and structural complications were collected. Main outcome measures, including visual impairment and incidence rate of ocular complications, were analyzed.

Results: Thirty-one patients (59 eyes) were included in the study. Follow-up data were available for 24 patients (47 eyes) with a mean follow-up time of 3.4 years (range, 2 months to 8.7 years). In the affected eyes with follow-up, the incidence rate of visual impairment to 20/50 or worse was 0.06 per eye-year (EY) (95% confidence interval, 0.022/EY–0.114/EY). The incidence rate of visual loss to 20/200 or worse was 0.006/EY (95% confidence interval, 0.0001/EY–0.034/EY). Thirty-six eyes (77%) had an ultimate visual acuity of 20/40 or better. All of the 13 patients with more than ≥3 years of follow-up had a visual acuity of ≥20/40 in at least 1 eye at 3 years after presentation. Two thirds of the follow-up patients (67%) on immunomodulatory drug therapy did not have new or recurrent CNV. However, this was not a statistically significant difference. Three eyes with follow-up had recurrence of CNV for an incidence rate of 0.04/EY (95% confidence interval, 0.008/EY–0.12/EY). Two eyes developed new CNV during follow-up for an incidence rate of 0.02/EY (95% confidence interval, 0.002/EY–0.066/EY).

Conclusion: The visual prognosis in most cases of punctate inner choroidopathy is very good. The incidence rate of new CNV and recurrent CNV was 0.02/EY and 0.04/EY, respectively.

This is a cohort study of patients diagnosed with punctate inner choroidopathy. The authors examine the incidence rate of vision impairment of 20/50 or worse, vision loss of 20/200 or worse, and other ocular complications, including new and recurrent choroidal neovascularization.

*Division of Ocular Immunology, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland;

Department of Ophthalmology and Visual Sciences, Division of Retina, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland;

Stanley M. Truhlsen Eye Institute, University of Nebraska Medical Center, Omaha, Nebraska; and

§Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.

Reprint requests: Jennifer E. Thorne, MD, PhD, Division of Ocular Immunology, Department of Ophthalmology and Epidemiology, The Wilmer Eye Institute, Johns Hopkins School of Medicine, 600 North Wolfe Street, Woods Building, Rm 476, Baltimore, MD 21287; e-mail:

Q. D. Nguyen is consultant for Bausch & Lomb and Santen and received grants from Genentech, Acucela, and Regeneron. J. E. Thorne is consultant for Navigant and Gilead, and received grants from Abbott, XOMA, Allergan, the Research to Prevent Blindness, and the National Health Institute). The other authors have no financial/conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.