From the Research
Punctate inner choroidopathy (PIC) is associated with several rheumatological diseases, including sarcoidosis, systemic lupus erythematosus (SLE), and inflammatory bowel disease (IBD), as evidenced by the most recent and highest quality study 1. PIC is a rare inflammatory chorioretinopathy characterized by multiple small, well-defined, yellow-white lesions in the posterior pole of the eye that can lead to vision loss. In rheumatological contexts, these associations occur because PIC shares common immunological pathways with these systemic inflammatory conditions. The underlying mechanism involves T-cell mediated immune responses and inflammatory cytokine production that affects both the choroid and retina. Some key points to consider in the management of PIC include:
- The importance of early diagnosis and treatment to prevent permanent vision loss
- The use of immunosuppressive therapy, with corticosteroids as first-line treatment
- The potential need for immunomodulatory agents or biologics in steroid-resistant cases
- The role of regular ophthalmologic examinations in monitoring for ocular complications like PIC in patients with known rheumatological diseases. As noted in the literature, managing PIC presents multiple challenges for clinicians, including variable disease severity, the need to distinguish between primary causes of vision loss, and deciding on maintenance therapy 1. Treatment must be tailored to the individual patient's circumstances, taking into account the extent of disease and the risk of progression, as well as the potential risks and benefits of different treatment options 2, 3. Overall, a comprehensive approach to diagnosis and treatment, incorporating the latest advances in imaging and therapy, is essential for optimizing outcomes in patients with PIC.