{"id":12705,"date":"2024-10-11T17:12:17","date_gmt":"2024-10-11T15:12:17","guid":{"rendered":"https:\/\/valintermed.com\/?p=12705"},"modified":"2024-10-11T17:12:17","modified_gmt":"2024-10-11T15:12:17","slug":"tochechnaya-vnutrennyaya-horioidopatiya","status":"publish","type":"post","link":"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/","title":{"rendered":"Punctate internal choroidopathy"},"content":{"rendered":"<div class=\"fpm_start\"><\/div>\n<p>Punctate internal choroidopathy (PIC) is an eye disease characterized by the formation of multiple small structures resembling punctate infiltrates in the choroid and retina. These changes can lead to scotomas, decreased visual acuity, and other visual disturbances. Punctate internal choroidopathy is usually of an autoimmune nature and can manifest as a systemic disease, affecting various organs and systems. It is important to note that this condition can be both isolated and associated with other pathologies, such as viral infections and autoimmune disorders. Punctate because the changes are located in characteristic points, and internal because of their localization in the inner layers of the retina and choroid.<\/p>\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_85 counter-flat ez-toc-counter ez-toc-light-blue ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Content<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" 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href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\" >History of the disease and interesting historical facts<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\" >Epidemiology<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\" >Genetic predisposition to this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Risk factors for the development of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Diagnosis of this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\" >Treatment<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >List of medications used to treat this disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Disease monitoring<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\" >Age-related features of the disease<\/a><\/li><li class='ez-toc-page-1'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/valintermed.com\/en\/medlibrary\/localized-internal-horioidopathies\/#%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\" >Questions and Answers<\/a><\/li><\/ul><\/nav><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%D0%98%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%8F_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F_%D0%B8_%D0%B8%D0%BD%D1%82%D0%B5%D1%80%D0%B5%D1%81%D0%BD%D1%8B%D0%B5_%D0%B8%D1%81%D1%82%D0%BE%D1%80%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D0%B5_%D1%84%D0%B0%D0%BA%D1%82%D1%8B\"><\/span>History of the disease and interesting historical facts<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The history of punctate internal choroidopathy is full of interesting episodes and important discoveries. The first cases of the disease were recorded at the beginning of the 20th century, but systematic study of TIC began only in the 1970s. Scientific research at that time helped to find out that the disease is associated with inflammatory processes in the choroid and retina. Based on these observations, diagnostic and treatment methods based on the use of immunosuppressive therapy began to be developed. One of the first articles devoted to TIC was published in the journal Ophthalmology, where a case of a patient with a typical clinical picture of the disease was presented. Another interesting fact is that the only agent capable of causing punctate internal choroidopathy remained unknown for a long time, which made diagnosis difficult. The successful discovery of the association of the disease with the herpes virus in 1995 opened up new horizons in understanding the pathogenesis and treatment of this disease.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%AD%D0%BF%D0%B8%D0%B4%D0%B5%D0%BC%D0%B8%D0%BE%D0%BB%D0%BE%D0%B3%D0%B8%D1%8F\"><\/span>Epidemiology<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The epidemiology of punctate internal choroidopathy is a topic of active study, especially in the context of its prevalence and risk factors. Studies show that the incidence of IPC varies depending on the population, but averages 1 to 3 cases per 100,000 people per year. Young and middle-aged individuals, mainly aged 20 to 50 years, are most susceptible to the disease. In clinical practice, it is noted that women may have a higher risk of developing IPC than men, which suggests a possible role of sex hormones. Some ethnic groups also have a high predisposition to the disease, indicating genetic and environmental components in its pathogenesis. The diversity of clinical manifestations requires a more in-depth epidemiological assessment to determine the characteristic features and risk factors in different populations.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%93%D0%B5%D0%BD%D0%B5%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B0%D1%8F_%D0%BF%D1%80%D0%B5%D0%B4%D1%80%D0%B0%D1%81%D0%BF%D0%BE%D0%BB%D0%BE%D0%B6%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D1%8C_%D0%BA_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%BC%D1%83_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8E\"><\/span>Genetic predisposition to this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Research aimed at understanding the genetic predisposition to punctate inner choroidopathy has identified a number of genes and mutations associated with the disease. One of the key areas is genetic analysis in families with cases of TIC. The main genes involved in the pathogenesis of the disease include HLA-DR2 and HLA-A29, which are associated with an increased risk of developing inflammatory diseases of the eye. Mutations in these genes can lead to abnormal functioning of the immune system, promoting autoimmune responses against cells of the choroid and retina. Additionally, polymorphisms in the genes of cytokines such as IL-6 and TNF-\u03b1 are also being investigated for their impact on the development of TIC. Genetic research in this area is ongoing, and further discoveries may change the understanding of the diagnosis and treatment of the disease.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A4%D0%B0%D0%BA%D1%82%D0%BE%D1%80%D1%8B_%D1%80%D0%B8%D1%81%D0%BA%D0%B0_%D0%B2%D0%BE%D0%B7%D0%BD%D0%B8%D0%BA%D0%BD%D0%BE%D0%B2%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Risk factors for the development of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>There are several risk factors that contribute to the development of punctate internal choroidopathy, which can be divided into physical, chemical and others. Important factors include:<\/p>\n<ul>\n<li>Smoking: Several studies have shown that smoking is associated with an increased risk of developing inflammatory eye diseases, including TBH.<\/li>\n<li>Viral infections: Infections caused by herpes zoster and cytomegalovirus viruses may aggravate the disease.<\/li>\n<li>Immune disorders: Having autoimmune diseases such as systemic lupus erythematosus may increase susceptibility to TBH.<\/li>\n<\/ul>\n<p>Note: This is an active area of research, and new risk factors may be identified as the pathogenesis of the disease continues to be studied. For example, recent data point to the role of stress and psycho-emotional factors in the development and exacerbation of TBH.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%94%D0%B8%D0%B0%D0%B3%D0%BD%D0%BE%D1%81%D1%82%D0%B8%D0%BA%D0%B0_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Diagnosis of this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>The diagnosis of punctate internal choroidopathy is based on a combination of clinical observations, laboratory tests and instrumental methods. The main symptoms include:<\/p>\n<ul>\n<li>The appearance of cattle in the field of vision;<\/li>\n<li>Decreased visual acuity;<\/li>\n<li>Changes in color perception.<\/li>\n<\/ul>\n<p>Laboratory tests may include serologic testing for viral infections such as herpes and a complete blood count to evaluate for inflammatory processes. Radiologic tests such as fluorescein angiography and optical coherence tomography (OCT) can visualize changes in the choroid and retina, revealing characteristic dots typical of TBH. <\/p>\n<p>It is also important to perform a differential diagnosis to exclude other diseases such as granular choroidopathy, infectious choroiditis and eye tumors. This allows for an accurate diagnosis and appropriate treatment.<\/p><script data-noptimize=\"\" data-wpfc-render=\"false\">\nfpm_start( \"true\" );\n<\/script>\n\n<h2><span class=\"ez-toc-section\" id=\"%D0%9B%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D0%B5\"><\/span>Treatment<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Treatment of focal internal choroidopathy is multifaceted and individualized, including both conservative and surgical approaches. General treatment includes the following strategies:<\/p>\n<ul>\n<li>Immunosuppressants: administration of glucocorticoids and other immunosuppressive drugs to reduce inflammation.<\/li>\n<li>Antiviral therapy: In cases involving viral infections, antiviral drugs may be used.<\/li>\n<li>Surgery: In cases where conservative treatment is ineffective, surgery may be indicated to correct severe manifestations of the disease.<\/li>\n<\/ul>\n<p>Pharmacological treatment involves the use of drugs such as methylprednisolone or azathioprine, as well as newer biological agents that target specific immune targets. It is important to consider the individual patient characteristics, the level of disease activity, and the presence of comorbidities when choosing a therapeutic strategy.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%A1%D0%BF%D0%B8%D1%81%D0%BE%D0%BA_%D0%BB%D0%B5%D0%BA%D0%B0%D1%80%D1%81%D1%82%D0%B2_%D0%BF%D1%80%D0%B8%D0%BC%D0%B5%D0%BD%D1%8F%D0%B5%D0%BC%D1%8B%D1%85_%D0%B4%D0%BB%D1%8F_%D0%BB%D0%B5%D1%87%D0%B5%D0%BD%D0%B8%D1%8F_%D0%B4%D0%B0%D0%BD%D0%BD%D0%BE%D0%B3%D0%BE_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>List of medications used to treat this disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Medications used to treat punctate internal choroidopathy include:<\/p>\n<ul>\n<li>Methylprednisolone;<\/li>\n<li>Azathioprine;<\/li>\n<li>Retuximab;<\/li>\n<li>Acyclovir;<\/li>\n<li>Cyclosporine.<\/li>\n<\/ul>\n<p>The choice of a specific drug and dosage should depend on the clinical situation and the body&#039;s response to therapy. Continuous monitoring of the patient&#039;s condition and correction of therapy if necessary are necessary.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%9C%D0%BE%D0%BD%D0%B8%D1%82%D0%BE%D1%80%D0%B8%D0%BD%D0%B3_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Disease monitoring<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Monitoring of punctate internal choroidopathy involves regular assessment of visual function and observation for possible complications such as retinal detachment and cataract development. Monitoring steps may include:<\/p>\n<ul>\n<li>Regular eye examinations;<\/li>\n<li>Optical coherence tomography for assessing the condition of the choroid and retina;<\/li>\n<li>Fluorescein angiography for visualization of vascular changes.<\/li>\n<\/ul>\n<p>The prognosis for patients with TBH can vary: in some cases, the disease may resolve on its own, while in others, it may lead to a significant decrease in visual acuity. Complications of the process can significantly worsen the quality of life, so early diagnosis and adequate treatment are key to improving the outcome.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%B7%D1%80%D0%B0%D1%81%D1%82%D0%BD%D1%8B%D0%B5_%D0%BE%D1%81%D0%BE%D0%B1%D0%B5%D0%BD%D0%BD%D0%BE%D1%81%D1%82%D0%B8_%D0%B7%D0%B0%D0%B1%D0%BE%D0%BB%D0%B5%D0%B2%D0%B0%D0%BD%D0%B8%D1%8F\"><\/span>Age-related features of the disease<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Punctate internal choroidopathy can manifest itself in different age groups, but the nature of the course and clinical manifestations may differ. In childhood, the disease is rare and usually occurs in a mild form, while in young and middle age it develops more actively and is accompanied by pronounced symptoms. In older people, TIC is usually associated with other degenerative diseases of the retina, which can complicate diagnosis and treatment. It is important to take into account age-related features when planning therapy and alternating methods of monitoring the patient&#039;s condition.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%D0%92%D0%BE%D0%BF%D1%80%D0%BE%D1%81%D1%8B_%D0%B8_%D0%BE%D1%82%D0%B2%D0%B5%D1%82%D1%8B\"><\/span>Questions and Answers<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<ul>\n<li><strong>What is punctate internal choroidopathy?<\/strong> This is a disease characterized by the formation of punctate infiltrates in the choroid and retina, usually of an autoimmune nature.<\/li>\n<li><strong>What is the epidemiology of internal choroidopathy?<\/strong> The incidence varies from 1 to 3 cases per 100,000 persons per year, with a higher incidence in young women.<\/li>\n<li><strong>What are the risk factors for this disease?<\/strong> Major risk factors include smoking, viral infections, and the presence of autoimmune diseases.<\/li>\n<li><strong>How is TVH diagnosed?<\/strong> Diagnosis is made using clinical observations, laboratory tests and instrumental methods such as OCT and fluorescein angiography.<\/li>\n<li><strong>What is the treatment for punctate internal choroidopathy?<\/strong> Treatment includes immunosuppressive drugs, antiviral therapy, and in some cases surgery.<\/li>\n<\/ul>\n<div class=\"fpm_end\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Punctate inner choroidopathy (PIC) is an eye disease characterized by the formation of multiple small structures resembling punctate infiltrates in the choroid and retina.<\/p>","protected":false},"author":1,"featured_media":22382,"comment_status":"open","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[298],"tags":[],"class_list":["post-12705","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medlibrary"],"_links":{"self":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12705","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/comments?post=12705"}],"version-history":[{"count":1,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12705\/revisions"}],"predecessor-version":[{"id":14374,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/posts\/12705\/revisions\/14374"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media\/22382"}],"wp:attachment":[{"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/media?parent=12705"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/categories?post=12705"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/valintermed.com\/en\/wp-json\/wp\/v2\/tags?post=12705"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}