Punctate inner choroidopathy is a very rarely diagnosed condition. It is basically an inflammatory condition of the eye which generally affects the myopic women. The condition is characterized by presence of multiple, small and well defined yellow white fundus lesions and usually intraocular inflammation is not associated. Punctate inner choroidopathy is often called PIC and is one of the so-called white dot syndromes. Punctate inner choroidopathy is only recognized as a distinct condition as recently as 1984. In this article we will mainly discuss Punctate inner choroidopathy along with its causes and how it can be managed using Ayurvedic formulations.
Punctate inner choroidopathy is a specific form of posterior uveitis and most commonly affects myopic women. It is characterized by multifocal, well circumscribed yellow white choroidal lesions present at the posterior pole of retina. These lesions are present without anterior or vitreous inflammation. Sometimes subfoveal lesions can result in symptoms like blurred vision, scotoma, metamorphosis and photopsia. Due to punctate inner choroidopathy does not usually cause severe visual loss. But if there is development of choroidal neovascularization and it develops in around 70% of patients with PIC. In treatment generally oral corticosteroids are generally recommended along with several therapies.
Causes of Punctate inner choroidopathy
- There is some evidence that suggests that PIC is an Autoimmune condition which means the immune system starts attacking its own healthy cells.
- Later due to significant inflammation, sometimes some new blood vessels also grow in through the inflamed spots thus may leak and cause central vision loss.
Signs and Symptoms of Punctate inner choroidopathy
As mentioned above the condition is quite common in myopic women (females who are short sighted). On an average the women with age between 27-30 years are at a risk of developing PIC. Patients are usually healthy, but still the autoimmune changes are triggered and precede.
The most common symptoms observed areas as follows
- The inflammation is confined to the back of the eye or can be understood as the posterior part of the eye.
- Generally both eyes are affected.
- There is no inflammation in the anterior chamber or vitreous which is the clear jelly inside the eye. This is the most distinguishing feature of PIC.
- Both of the eyes are affected.
- There is the appearance of gray white or yellow punctuated or punched out areas. These areas can also be understood as the areas of lesion. These are present at the level of the inner choroid. These lesions are typically located centrally at the back of the eye which is called the posterior pole.
Symptoms of PIC
Symptoms include blurring of vision along with partial blind spots. These partial blind spots are called scotoma. These are basically the diminished or lost areas of the visual field and are typically near the centre of vision. But occasionally they can also be peripheral. These may be temporary or permanent. Even patients also complain about seeing flashing lights. The PIC lesions, which are responsible for scar formation, can be of deep nature present in the choroid layer of the eye. This may result in new blood vessels forming. These can arise as the body’s attempts at repair, but these new blood vessels (neovascularization). If the neovascularization is observed then it is basically a sign that the situation has become difficult and the patient has landed in complications.
Diagnosis of PIC
The diagnosis of this condition is difficult and may appear similar to other conditions like posterior uveitis and other forms of so-called white dot syndromes. Mostly the tests which are performed in this condition includes:
- Visual field testing
- Fluorescein angiography, in which intravenous dye is used to show the blood vessels at the back of the eye.
Treatment of PIC
Treatment firstly includes observation. Observation is very appropriate for the lesions, when they are found in the mom sight threatening areas which means they are not present centrally. But in case the patient lands in complications like CNV (choroidal neovascularization). Then the following treatment is generally guided:
- Corticosteroids which can be systemic or intraocular.
- Secondly Immunosuppressants are recommended as there is evidence that combined therapies of steroids and second line immunosuppressants may be helpful.
- Surgical excision can also be done of the affected area in well selected cases.
- Intravitreal anti-VEGF agents. For Examples Bevacizumb (avastin) and ranibizumab. These relatively new drugs which are injected into the eye.
- Photodynamic therapy (PDT) which is a photosensitive drug and is ‘activated’ by strong light. Generally it is advised to give combined therapy of PDT and anti VEGF.
- Laser photocoagulation: This is occasionally used unless the CNV is subfoveal (affecting the central or macular part of the vision). The laser treatment can damage the vision.
Herbal Formulations for Punctate Inner Choroidopathy by Planet Ayurveda
Planet Ayurveda is a leading Ayurvedic firm which deals with the manufacturing of herbal formulations. These formulations are prepared using potent herbs who are really effective in managing many conditions related to eyes. The formulations prepared by Planet Ayurveda do not contain any kind of adulterants, dyes, additives, fillers etc. These medications are really potent to manage various conditions related to eyes especially and are very fruitful hence giving positive noticeable results. The medication or formulations offered by Planet Ayurveda for the management of Punctate inner choroidopathy is as follows
- Angel Eye Vitale
- Kaishore Guggul
- Bilberry Capsules
- Triphala Ghrit
- Saptamrit loha
- Curcumin Capsules
1. Angel Eye Vitale
Angel eye vitale capsules have ingredients like pure extract of vitamin C, vitamin E, zinc, marigold, corn, carrot seed and bilberry. The formulation is very effective in various eye related disorders and also helps in enhancement of eye sight. In case of any irritation due to PIC the formulation can be given and is very effective in managing such conditions.
Dosage: One capsule twice a day after meals with lukewarm water.
2. Kaishore Guggul
Kaishore guggul has many ingredients like amalaki (Emblica officinalis), haritaki (Terminalia chebula), Guduchi (Tinospora cordifolia), Ginger (Zingiber officinale), black pepper (Piper nigrum) and many others. It is a classical preparation which is being used to remove toxins from the body and also supports healthy blood circulation. The formulation tends to show a rejuvenating effect on the body. This formulation is very popular for its fantastic effects.
Dosage: Two tablets twice a day after meals with lukewarm water.
3. Bilberry Capsules
Bilberry which is also called Vaccinium myrtillus.. This is a single herb formulation and is one of the best medications which is used in the treatment of eye disorders. These capsules are made from pure extract of bilberry. It has antioxidant properties and is successfully used in treatment of disorders related to retina, cataracts, nearsightedness and glaucoma. Bilberry is also used to enhance night vision.
Dosage: One capsule twice a day after a meal with plain water.
4. Triphala Ghrit
The formulation is prepared using Amalaki (Emblica officinale), Bibhitaki (Terminalia bellirica), Haritaki (Terminalia chebula), madhuka (Glycyrrhiza glabra), Katukarohini (Picrorhiza kurroa), etc. This formulation relieves itching, discharge, strain or pains of eyes. This ayurvedic formulation is tridoshghan and is loaded with rasaynik properties of triphala for eyes. It helps in preventing onset of neovascularization.
Dosage: One tsp with warm water twice a day
5. Saptamrit loha
The saptamrit loha is also having Triphala as its main content along with Iron calx (Bhasma) and Licorice which boosts immunity by increasing the blood cells. This makes it an efficient anti pathogenic formulation and improves systemic wellbeing. It helps in enhancing the immunity and protects eyes against the damage.
Dosage: One tablet twice a day with plain water after meals
6. Curcumin Capsules
Curcumin capsules contain standardized extract of Curcumin longa which is having anti bacterial, anti inflammatory and analgesic properties. It helps in reducing the inflammation present in the PIC and also enhances overall immunity of the body.
Dosage: One capsule twice a day after meals.
In Ayurveda the chikitsa of each and every disorder or disease is possible whether it is systematic or pathological. All we need to do is gather knowledge and have belief. A proper understanding of condition and body according to Ayurveda can help you in understanding the situation really well and can do miracles in managing a condition. After a deep understanding choosing Ayurvedic herbs wisely helps in treating disorders really well. Above mentioned products by Planet Ayurveda are totally herbal and organic. In addition they do not cause any kind of side effects.