Punctate Inner Choroidopathy (PIC) disease recurrence with inflammatory choroidal neovascular membrane (iCNVM) post-COVID-19 vaccine.

PURPOSE: To report a recurrence of punctate inner choroidopathy (PIC) with an inflammatory choroidal neovascular membrane (iCNVM) after the Pfizer-BioNTech COVID-19 vaccine. METHODS: Case report. RESULTS: A 38-year-old female with a history of myopia and previous episodes of PIC and iCNVM presented with distorted vision in her right eye, seven days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. The patient exhibited active PIC lesions with iCNVM confirmed on multimodal imaging. Treatment with a combination of oral corticosteroids and intravitreal anti-VEGF injection led to disease resolution. Subsequent COVID-19 vaccinations, administered while the patient was immunosuppressed, did not lead to disease relapse. However, relapse occurred following the fourth COVID-19 vaccine, when the patient was not immune suppressed. CONCLUSION: This case highlights the potential risk of PIC disease relapse following COVID-19 vaccination. Further research is needed to investigate the relationship between COVID-19 vaccination and PIC exacerbation, as well as to determine optimal management strategies in this population, including close observation and consideration of prophylactic immune suppression at the time of COVID-19 vaccine for high-risk individuals.

Unilateral solitary choroidal tuberculoma as the presenting sign in disseminated tuberculosis in an immunocompetent patient.

INTRODUCTION: Tuberculosis can involve any organ in the body including ocular tissue of which the uveal tissue is most commonly infected. Choroidal involvement ranges from choroidal tubercles to granulomas. This is one of the few cases of a solitary choroidal granuloma with no other systemic symptoms in an immunocompetent child. METHOD: A case report. RESULTS: A 12-year-old female, presented with diminution of vision in the left eye for a month. The anterior segment of her left eye was normal. A fundus examination revealed an isolated orangish-yellow choroidal mass, 4 DD in size, involving the posterior pole with overlying subretinal exudation. CT scan of the thorax showed large pulmonary, cervical and pancreatic lymph nodes, along with lytic lesions of the thoracic vertebrae. Excision biopsy of the cervical lymph nodes showed caseating granulomas with no e/o malignancies on histopathology. The patient was started on anti-tubercular therapy. Six months after the treatment, the lesion had reduced in size and her vision had improved. CONCLUSION: Isolated choroidal tuberculomas can be present in eyes with little associated ocular inflammation and no other symptoms of systemic tuberculosis. High suspicion, early diagnosis and rapid initiation of medication are important for the treatment of ocular and systemic tuberculosis.

Evaluation of retinal and choroidal vascular structures in patients with anxiety disorder.

PURPOSE: To evaluate the retinal and choroidal vascular structures in patients with anxiety disorders. METHODS: Thirthy-four eyes of 34 patients who were diagnosed with any anxiety disorders were compared with 32 eyes of 32 age- and sex-matched controls. Central macular thickness (CMT), foveal vascular zone (FAZ) area, total retinal vascular densities of superficial and deep capillary plexus (VDSCP, VDDCP), outer retinal and choriocapillary layers (ORL, CCL) blood flow rates, central subfoveal choroidal thickness (SFCT) and choriodal vascularity index (CVI) were evaluated with optical coherence tomography angiography (OCT-A) and enhanced depth imaging optical coherence tomography (EDI-OCT). RESULTS: No statistical differences were found between the study and control groups in terms of CMT, FAZ area, VDSCP, VDDCP, ORL and CCL blood flow rates. The mean SFCT was 346.26 ± 64.26 µm in patients with anxiety disorder and was found to be statistically significantly thicker than the control group (319.56 ± 37.19 µm) (p = 0.042). Besides, CVI was significantly lower in the study group (71.09 ± 2.64 vs 73.13 ± 3.31, p = 0.008). CONCLUSION: In people with anxiety disorders, the SFCT was found to be thicker and CVI was found to be lower than normal subjects. Although anxiety and stress are important factors in central serous chorioretinopathy, multifactorial factors, including ocular factors, play a role in the pathophysiology of the disease. There is a need for prospective studies with larger series on the subject.