Development of Secondary Choroidal Neovascularization in Focal Choroidal Excavation of Punctate Inner Choroidopathy

ABSTRACT

Purpose: To elaborate a case of focal choroidal excavation (FCE) in punctate inner choroidopathy (PIC) complicated by secondary choroidal neovascularization (CNV) based on multimodal imaging findings.

Methods: In this retrospective case report, multimodal imaging including near-infrared reflectance, blue peak autofluorescence, spectral domain-optical coherence tomography (OCT), fluorescein and indocyanine green angiography (Heidelberg Engineering GmbH, Germany), and swept source-OCT angiography (SS-OCTA; Topcon Corporation, Japan) was performed.

Patients: A 27-year-old moderate myopic woman presented with inactive CNV of unknown origin in her left eye, which had been previously treated with intravitreal anti-vascular endothelial growth factor.

Results: Multimodal imaging revealed PIC as the causative disease and systemic corticosteroids were administered. Similar complaints 13 months later showed new CNV formation at the already documented FCE. No sign of PIC could be detected at follow-up.

Conclusion: This well-documented case highlighted FCE as the preferential location for CNV development in PIC with multimodal imaging emphasizing a chorioretinal entity.

Summary: This case report demonstrated the clinical course of focal choroidal excavation in a patient initially diagnosed with punctate inner choroidopathy complicated by choroidal neovascularization and its treatment response, well documented by multimodal imaging including optical coherence tomography angiography.

Keywords:

• Choroidal neovascularization
• focal choroidal excavation
• punctate inner choroidopathy
• swept source-optical coherence tomography angiography

AUTHOR CONTRIBUTIONS

Anna-Maria Haas and Martin Stattin had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Karl Landsteiner Institute for Retinal Research and Imaging, Vienna, Austria

Acquisition, analysis or interpretation of data: Anna-Maria Haas, Martin Stattin, Daniel Ahmed, Ilse Krebs, Siamak Ansari-Shahrezaei

Drafting of the manuscript: Martin Stattin

Critical revision of the manuscript for important intellectual content: Daniel Ahmed, Ilse Krebs, Siamak Ansari-Shahrezaei

Obtained funding: none

Administrative, technical or material support: Carl Glittenberg

Study supervision: Siamak Ansari-Shahrezaei

DECLARATION OF INTEREST

All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported. The authors have not published or submitted any related papers from this study.

Additional information

Funding

No funding contributed to support this study. The Karl Landsteiner Institute currently receives a Research Grand from Topcon Europe BV. OCTA images were captured by a beta version of Topcon’s Triton Swept Source-OCTA. The computing and post-processing of the figures was supported by Senior Clinical Advisor Carl Glittenberg, a Topcon employee.