A Case of Punctate Inner Choroidopathy in the Fellow Eye Followed by the Development of Solitary Punctate Chorioretinitis With Choroidal Neovascularization.

We present the clinical course of a patient who developed punctate inner choroidopathy (PIC) followed by solitary punctate chorioretinitis (SPC), and subsequently developed choroidal neovascularization (CNV) after a prolonged period. We also discuss the importance of examination and diagnosis using multimodal imaging, as well as the significance of follow-up. A 35-year-old woman with high myopia presented with a one-week history of central visual disturbance in her left eye. Examination revealed multiple white dots in the left macula, but none in the right eye. Based on multimodal imaging findings typically for PIC, she was diagnosed with PIC and placed under observation. Three years after the initial visit, a solitary white dot appeared superonasal to the fovea in the right macula, leading to a diagnosis of SPC based on multimodal imaging. Although findings in both eyes gradually worsened thereafter, no CNV was observed. Thirteen and a half years after the onset of right eye findings, she presented with a complaint of rapid vision loss, and CNV was detected in the right eye; no CNV was observed in the left eye. Based on these results, the CNV was attributed to the SPC in the right eye, and treatment involving intravitreal anti-vascular endothelial growth factor agent injections and sub-Tenon's injections of triamcinolone acetonide was initiated. In this case, CNV developed 13 years after the confirmation of SPC. Thus, for cases of unilateral PIC, it is essential to bear in mind the potential for developing SPC and the subsequent risk of CNV arising from SPC over the long term, and to conduct regular evaluations using multimodal imaging.