Clinical characteristics and prognosis of solitary punctate chorioretinitis in Chinese patients

To describe a case series of solitary punctate chorioretinitis (SPC), a subtype of punctate inner choroidopathy (PIC) characterized by solitary macular lesions.

This retrospective, consecutive case series included patients diagnosed with SPC over a 5-year period, all of whom had a minimum follow-up of 6mo. Baseline and multimodal imaging data were analyzed to assess clinical presentations and prognosis.

All patients (n=17) were Chinese and myopic, with a female predominance (12/17, 70.6%). The mean age was 31y (range, 18–42y). The median refractive error of the affected eyes was -4.6 diopters (D; range, -14.5 to -0.75 D). Ophthalmoscopically, the lesions presented as solitary, yellow-white dots in the macula. On fundus fluorescein angiography (FFA), most lesions (15/17, 88.2%) appeared hyperfluorescent, with slight leakage observed in 3 cases (17.6%). Indocyanine green angiography (ICGA) revealed hypofluorescence in nearly all cases (16/17, 94.1%). Following a three-month course of oral glucocorticoids, most lesions (11/17, 64.7%) showed reduction or resolution. During follow-up, five patients (29.4%) developed secondary macular neovascularization (MNV), indicating a more severe disease course. Recurrences were observed in six patients. At the final visit, focal choroidal excavation was present in four patients (23.5%).

SPC is a rare subtype of PIC, characterized by a favorable prognosis, although late recurrences are possible. Accurate diagnosis necessitates differentiating it from MNV. Early intervention with oral glucocorticoids appears to be an effective therapeutic strategy.