Punctate inner choroidopathy (PIC)
Punctate inner choroidopathy (PIC) is a rare condition caused by inflammation at the back of the eye. It is more common in women, and in short-sighted people.
What causes PIC?
We do not fully understand what causes PIC, although there is some evidence that it may be an autoimmune condition. This means that instead of fighting off bugs, the immune system starts to attack healthy tissue.
PIC causes small patches of inflammation in the retina and choroid. Sometimes new abnormal blood vessels grow through the inflamed spots and leak, which can lead to a sudden loss of central vision.
What are the symptoms?
Common symptoms are missing or blurred patches in your vision, "floaters", flashes of light, or things looking distorted. In PIC, an optician or ophthalmologist should be able to see the patches of inflammation as white dots.
People often notice symptoms for the first time as young adults, and it usually affects both eyes at the same time.
How is it treated?
Treatments for PIC fall into short-term 'rescue' and long-term 'prevention'. Rescue treatments use corticosteroid tablets or injections to suppress the inflammation, or anti-VEGF injections to stop new blood vessels spreading and leaking.
Once inflammation is brought under control, preventative treatment may be used to reduce the risk of a future flare-up.
These preventative treatments include immune system-suppressing tablets or a corticosteroid implant in your eye. If your PIC is mild, you may not be prescribed a preventative therapy, and only take 'rescue' medication, if and when, needed.
Research into PIC
There are many things we do not yet understand about PIC: whether there is a hormonal factor (which might explain why it normally occurs in young women) and why it mainly affects short-sighted people.
Good progress is being made in detecting and monitoring PIC. Changes in the retina of just a few thousandths of a millimetre can now be measured. This improved monitoring means the smallest possible dose of treatment can rescue a flare-up and prevent further inflammation.
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Last review date: 08 2021
Next review date: 12 2023
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