Primary Inflammatory Choriocapillaropathy Rupesh Agrawal, Carlos Pavesio Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom

Ocular History 24 year old, male, Asian 24 year old, male, Asian RE: complaints of small scotomas since few months, RE: complaints of small scotomas since few months, Ocular history: Non-significant Ocular history: Non-significant

General History History of TB exposure History of TB exposure no other history of preceding viral illness no other history of preceding viral illness

First Presentation  OD:  VA: RE- 6/12, LE- 6/6  SLE: AC – no cells, no flare, lens clear  no vitreous cells  no retinitis or vasculitis  color vision: Normal  no RAPD  OS: normal

First Presentation - OD: Fundus, FFA, ICGA  serpiginoid coalescing lesions on fundus photograph  FFA: hyperfluorescent lesions on early phase becoming more hyperfluorescence in late phase  blocked fluorescence on ICGA, also showing presence of blocked high resolution,  high magnification Fluorescence of the lesion using FFA

First Presentation – Autofluorescence OD hyperfluorescence involving fovea

First Presentation - Spectralis OCT  OD: loss of inner segment /outer segment photoreceptor layer in the foveal and parafoveal region  OS: normal OCT

First Presentation - Spectralis OCT and IR OD  loss of inner segment /outer segment photoreceptor layer with intraretinal fluid

Diagnosis  Atypical Acute placoid multifocal posterior pigment Epitheliopathy or Atypical Ampiginous choroiditis or Atypical relentless placoid pigment epitheliopathy  based on  clinical findings  FFA, ICGA features  Autofluorescence

Treatment  as involving visual axis – treated with oral steroids 60mg/day for 1week in tapering dose  blood tests:  routine tests: normal  Quantiferon-Gold & syphillis: negative

Follow up – After 1 weeks  resolving lesion in the OD  VA: OU- 6/5  treatment – tapering steroids every week and stopped after six weeks

Follow up – After One week Autofluorescence OD  Lesion resolving

Follow up – After 1 week OCT and IR  significant resolution of the lesion

Final follow up – After 4 Months no recurrence of the lesion no recurrence of the lesion VA: OU: 6/5 VA: OU: 6/5 no cells, no flare. no cells, no flare. scarred lesion parafoveal and normal AF scarred lesion parafoveal and normal AF