Punctate Inner Chorioretinopathy (PIC), is a unique and relatively uncommon eye condition affecting the inner layers of the choroid and retina. It is a form of uveitis that we see regularly at The Retina Clinic London and in which we have great expertise, diagnosing, managing, and treating.
What is Punctate Inner Chorioretinopathy (PIC)?
Punctate Inner Chorioretinopathy (PIC) is a distinctive form of chorioretinopathy characterized by small, yellowish-white lesions or spots within the inner layers of the choroid and retina. Chorioretinopathy is a general term used to describe various eye conditions that affect both the choroid and the retina, the two essential layers at the back of the eye.
How does it present in the eye?
PIC presents as small, punctate lesions scattered throughout the posterior pole of the eye, particularly in the macular region. PIC primarily affects the inner choroid and retina, which sets it apart from other chorioretinopathies. [image]
PIC is commonly diagnosed in young to middle-aged adults, and our specialized team at The Retina Clinic London has experience in providing targeted care to adults of all ages with this condition.
What are the causes of PIC?
There are several factors which can contribute to having PIC but the two principal ones are:
Immunological Factors: Investigating the potential autoimmune or inflammatory components associated with PIC is important as the immune system plays a large role in this condition.
Genetic Predisposition: You may have a genetic predisposition to be susceptible to PIC.
What are the symptoms of PIC?
The following symptoms may be signs of PIC and warrant a consultation at The Retina Clinic London to properly diagnose your condition:
Visual Disturbances: persistent blurred or distorted central vision.
Vitreous Floaters and Opacities: these opacities are secondary to vitritis or inflammation of the vitreous (the gel which fills the middle of your eye). These floaters with the correct treatment will disappear of their own accord.
How is PIC diagnosed at The Retina Clinic London?
Our clinic employs cutting-edge diagnostic tools to accurately assess PIC, including:
- Ultrawidefield Multi-Wavelength Fundus Photography: High-resolution imaging capturing detailed views of up to 80% of the retina and choroid in one image.
- Ultra widefield Fundus Fluorescein Angiography and Indocyanine Green Angiography: this is a specialised imaging technique involving injecting a dye into the vein of your arm and imaging it when it reaches the blood vessels in your eye with a special light wavelength. This information allows your consultant to see the extent of any inflammation, fluid build-up, and lesions in the retina and choroid.
- Ultra widefield Optical Coherence Tomography (OCT): state-of-the-art imaging for cross-sectional views of the retina and choroid, aiding in lesion characterization.
Electroretinography: testing of the electrical activity in the photoreceptor cells in the retina (cells which perceive light and permit vision) as a way of diagnosing inflammation.
What treatment options are there for PIC?
As with all conditions, at The Retina Clinic London, we only offer a treatment plan which is curated and targeted to your specific diagnosis and symptoms. Not all patients respond in the same way to medications and so adhering to the follow-up plan set by your ophthalmologist is key to ensuring success.
For PIC, treatment plans will revolve around the following medications and actions:
Corticosteroids: Targeted administration to reduce inflammation and manage symptoms.
Immunosuppressive Medications: tailored treatments for cases involving recurrent or severe inflammation.
Ongoing Monitoring: regular follow-ups to track progress and adjust treatment plans as needed.