Baseline Patchy Hyperautofluorescence A Risk Factor for Punctate Inner Choroidopathy Recurrence

a young ophthalmologist using a non-mydriatic retinal camera on a young girl
Researchers explain how shortwave fundus autofluorescence findings can guide follow-up.

Patchy hyperautofluorescence on shortwave fundus autofluorescence (SW-FAF) at baseline is a risk factor for punctate inner choroidopathy recurrence, according to a study published in Photodiagnosis and Photodynamic Therapy. Researchers believe the finding could help determine which cases are best suited for close follow-up even after inflammation reduction.

The retrospective observational study looked at factors in both clinical data and imaging at baseline that could potentially correlate with punctate inner choroidopathy recurrence risk. Researchers examined the charts and multimodal imaging of 45 patients who had punctate inner choroidopathy in the active inflammatory phase. A punctate inner choroidopathy diagnosis was made using either fundus photography, SW-FAF, fluorescein angiography (FA), indocyanine green angiography (ICGA), or spectral domain optical coherence tomography (SD-OCT), or a combination.

Baseline multimodal imaging parameters were used to determine potential biomarkers for inflammation recurrence. Statistical analysis was used to determine clinical and imaging factors that might be involved.

They found that of the 45 patients included, 18 (40%) had at least 1 recurrence during the follow-up period. Patchy hyperautofluorescence at baseline occurred in about 77.78 % of those with recurrence. And incidence of patchy hyperautofluorescence was significantly different between those who had a recurrence and those who didn’t (P <.001).

In addition, investigators found a significant difference between the group with recurrence and the group without in best corrected visual acuity (BCVA) at the final visit (the mean follow-up period was 23.66 ± 12.65 months, range, 12 months to 50 months).

“Patchy hyperautofluorescence on SW-FAF is significantly and independently associated with a higher risk of recurrence in eyes affected with [punctate inner choroidopathy]. Combined with multimodal imaging findings, patchy hyperautofluorescence may suggest more severe inflammation of [punctate inner choroidopathy] [leading] to frequent recurrence,” the study says. “Autofluorescence is a useful and noninvasive tool in monitoring the prognosis of [punctate inner choroidopathy].” 

In addition, the research explains, “patchy hyperautofluorescence indicates the patients may have recurrence of [punctate inner choroidopathy] and close follow-up is needed for those patients.”

The study’s limitations included its retrospective design and small sample size with strict criteria (due, in part, to the relatively rare nature of the disease). They recommended further study, including with prospective studies that have larger sample sizes.


Gan Y, Su Y, Zhang Y, et al. Patchy hyperautofluorescence as a predictive factor for the recurrence of punctate inner choroidopathy. Photodiagnosis Photodyn Ther. 2021;33(3):102146. doi:10.1016/j.pdpdt.2020.102146.