Punctate Inner Choroidopathy (PIC)

Punctate Inner Choroidopathy (PIC)

Rare Disease Classifications:

ORPHA:580951 Punctate inner choroidopathy

ICD-11: 9B65.0 Noninfectious posterior uveitis

IMPORTANT INFORMATION

The information on the Rare Awareness Rare Education (RARE) Portal is intended for educational purposes only and does not replace professional advice.

Rare diseases typically display a high level of symptom complexity and variability. Individuals diagnosed with the same rare disease may be impacted differently and each person’s experience is unique. Please seek support from qualified healthcare professionals to learn more about the most suitable care and support options for you.

If you are aware of any additional information that may benefit stakeholders with an interest in this page, or if you notice any broken links or inaccurate information, please let us know via the Contribute page.

Emergency Management

There may be special considerations for the emergency management of individuals living with punctate inner choroidopathy (PIC) presenting to emergency departments.

Please note that individuals with PIC may have issues with their vision as well as sensitivity to light.

Clinical Care Guidelines

We are not aware of any clinical care guidelines for punctate inner choroidopathy (PIC) in Australia. If you know of any relevant care guidelines, please let us know via the Contribute page.

Synonyms

Punctate Inner Choroiditis

Summary

Punctate inner choroidopathy (PIC) is an inflammatory eye condition.1 It is characterised by the presence of multiple yellow-white lesions in the posterior pole of the eye and no other signs of inflammation in the rest of the eye.2-5 These yellow-white lesions are small, round and well-defined, and are found specifically at the level of the retinal pigment epithelium and inner choroid (part of the vascular layer) of the eye. PIC can affect either one, or both eyes.

 

PIC commonly affects younger females that are near-sighted (myopic or have trouble seeing objects from a distance).2-5 The disease course and severity of PIC may vary between individuals. In some cases, the condition can resolve spontaneously whilst in other cases there may be complications resulting in permanent loss of vision.2,3

Useful Links for Professionals

ORPHA:580951 Punctate inner choroidopathy

Personal Stories

Punctate inner choroidopathy (PIC) varies between individuals, and each person’s experience is unique.

If you would like to share your personal story with Rare Voices Australia and have it included on the RARE Portal, please visit Rare Voices Australia: Share Your Story.

Symptoms

Common symptoms of punctate inner choroidopathy (PIC) include:1-5

  • blurred vision
  • photopsia – perceived flashes of light
  • scotomas – blind spots in vision
  • floaters
  • photophobia – sensitivity to light
  • metamorphopsia – distorted vision, causing objects with straight lines to appear curved

Some individuals also experience loss of peripheral vision and are unable to see out of the corners of their eyes.2,3 PIC can affect one eye (unilateral) or both eyes (bilateral).

Symptoms of PIC may resolve spontaneously.2 There can also be complications associated with PIC, such as growth of abnormal blood vessels in the choroid (choroidal neovascularization, CNV) and formation of scar tissue beneath the retina (subretinal fibrosis), which can lead to impaired vision.2-4

Please speak to your medical team to learn more about the symptoms and complications of PIC.

Cause/Inheritance

The exact cause of punctate inner choroidopathy (PIC) is unknown (idiopathic). 2,3 It has been proposed that it could be an autoimmune condition, in which the body produces an immune response attacking the outer retina and inner choroid. There could also be the involvement of genetic and environmental factors.

Diagnosis

Diagnosis of punctate inner choroidopathy (PIC) is typically clinical, with the help of multimodal imaging to identify presence of the inflammatory lesions and signs of ongoing inflammatory activity.2 The imaging techniques may include fluorescein angiography, indocyanine green angiography, optical coherence tomography (OCT) imaging, fundus autofluorescence (FAF) imaging and OCT angiograph.2,3

Differential diagnosis (to rule out other conditions) may include presumed ocular histoplasmosis syndrome (POHS), progressive subretinal fibrosis and uveitis syndrome, acute posterior multifocal placoid pigment epitheliopathy, BCR, and multiple evanescent white dot syndrome.3

Please speak to your medical team to learn more about the available and suitable diagnostic pathways for PIC.

Treatment

There is currently no consensus treatment established for punctate inner choroidopathy (PIC).6 Treatment may depend on the symptoms and disease complications including primary cause of vision loss.2

Treatment may include corticosteroids, steroid-sparing immunomodulatory drugs, or intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy.2,6 In some cases, treatment may not be considered necessary, and individuals may just be monitored for disease progression and complications.

It is best to speak with your medical team to learn more about possible treatment strategies for PIC and to determine suitability of treatment. Treatment will depend on an individual’s specific symptoms and complications.

Clinical Care

Healthcare professionals involved in the treatment of punctate inner choroidopathy (PIC) may include general practitioners (GP) and ophthalmologists.1 The need for different healthcare professionals may change over a person’s lifetime and extend beyond those listed here.

Research and Data

Classification criteria for punctate inner choroiditis has been developed by the Standardization of Uveitis Nomenclature (SUN) Working Group (an international collaboration) for research purposes.

Please visit Australian Clinical Trials to learn about clinical trials for punctate inner choroidopathy (PIC) in Australia; there may not be any clinical trials currently available.

Information regarding clinical trials for punctate inner choroidopathy (PIC) in other countries can be found at ClinicalTrials.gov; there may not be any clinical trials currently available.

It is best to discuss your interest in any clinical trials with your medical team to determine suitability and eligibility.

Rare Disease Organisation(s)

We are not aware of any rare disease organisations for punctate inner choroidopathy (PIC) in Australia. If you are aware of any organisations, please let us know via the Contribute page. If you are interested in starting an Australian organisation for people living with PIC, please see Engaged, Ethical and Effective: A Guide for Rare Disease Organisation Leaders in Australia.

Support Services/Resources

For information on available government and social services that provide support for individuals with a rare disease, please visit the National and State Services pages.

Mental Health

People living with a rare disease, including families and carers, often face unique challenges such as diagnostic delays, misdiagnoses, limited treatment options, and limited access to rare disease specialists and support. These challenges may impact people’s emotional wellbeing and quality of life. Many people find it helpful to seek mental health and wellbeing support to cope with ongoing stress and uncertainty. Connecting with people who have shared experiences through a support group may also be helpful.

Information about relevant mental health and wellbeing support can be found at:

Other

Further information on punctate inner choroidopathy (PIC) can be found at:

References
  1. Genetic and Rare Diseases (GARD) Information Center. Punctate Inner Choroidopathy. Accessed 24 February 2025. https://rarediseases.info.nih.gov/diseases/7503/punctate-inner-choroidopathy
  2. Kalogeropoulos D, Rahman N, Afshar F, et al. Punctate inner choroidopathy: A review of the current diagnostic and therapeutic approaches. Prog. Retin. Eye Res. 2024; 99: 101235. https://doi.org/10.1016/j.preteyeres.2023.101235
  3. Ahnood D, Madhusudhan S, Tsaloumas M, et al. Punctate inner choroidopathy: A review. Surv. Ophthalmol. 2017;62(2):113-126. https://doi.org/10.1016/j.survophthal.2016.10.003
  4. Campos J, Campos A, Mendes S, et al. Punctate inner choroidopathy: A systematic review. Med. Hypothesis Discov. Innov. Ophthalmol. 2014;3(3):76-82. https://pmc.ncbi.nlm.nih.gov/articles/PMC4348489/
  5. Essex RW, Wong J, Fraser-Bell S, et al. Punctate Inner Choroidopathy: Clinical Features and Outcomes. Arch Ophthalmol.2010;128(8):982–987. https://doi.org/10.1001/archophthalmol.2010.157
  6. Thongborisuth T, Song A, Lobo-Chan AM. Punctate Inner Choroiditis. Adv. Ophthalmol. Optom. 2024 9(1):345-357. https://doi.org/10.1016/j.yaoo.2024.02.005
Page Last Updated

25/02/2025 16:12