J Korean Ophthalmol Soc.  2016 Mar;57(3):513-517. 10.3341/jkos.2016.57.3.513.

Management of Relapsed Inflammatory Choroidal Neovascularization in Punctate Inner Choroidopathy after Bevacizumab

• Kim HW
• Cho YW
• Chung IY

• KMID: 2213255
• DOI: http://doi.org/10.3341/jkos.2016.57.3.513

Abstract

PURPOSE
To report a rare case of relapsed inflammatory choroidal neovascularization (CNV) in a young female patient after intravitreal bevacizumab (IVB) treatment for subfoveal CNV secondary to punctate inner choroidopathy (PIC).
CASE SUMMARY
A 25-year-old myopic female presented with PIC complicated by subfoveal CNV in the right eye. Her lesion initially responded to three monthly 1.25 mg IVB injections, but the lesion recurred two months after the final injection, and the size of the lesion was larger than that observed before treatment. Further treatment with systemic steroids and IVB resulted in successful anatomic and visual improvement.
CONCLUSIONS
This report presents a rare case of relapsed inflammatory CNV in a young female patient after IVB treatment for subfoveal CNV secondary to PIC. Systemic steroid and IVB were performed after relapse, which successfully improved and maintained vision for longer than 18 months.

Keyword

Bevacizumab; Choroidal neovascularization; Punctuate inner choroidopathy

MeSH Terms

Adult
Choroid*
Choroidal Neovascularization*
Female
Humans
Recurrence
Steroids
Bevacizumab
Steroids

Figure

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  Figure 1. Fundus photograph, optical coherence tomography, Fluorescein angiography and indocyanine green angiography. (A) A fundus photograph demonstrates multiple, small, yellow, opaque, and round lesions scattered throughout the posterior pole of the right eye. (B) Optical coherence tomography shows the subfoveal choroidal neovascular membrane and subretinal fluid. (C) Fluorescein angiography demonstrates multiple small areas of hyperfluorescence in the right eye. (D) Indocyanine green angiography shows multiple small areas of hypofluorescence in the right eye. (E, F) The patient showed complete resolution of choroidal neovascularization with only a juxtafoveal atrophic scar at one month after the third intravitreal bevacizumab injection.

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  Figure 2. Fundus photograph, optical coherence tomography, Fluorescein angiography and indocyanine green angiography at two months after the final intravitreal bevacizumab injection. Fundus photograph (A) and optical coherence tomography (B) shows a larger number of extended multiple, small, yellow, opaque, and round lesions scattered throughout the posterior pole of the right eye. Fluorescein angiography and indocyanine green angiography (C, D) show more severe choroidal inflammation.

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  Figure 3. Fundus photograph, optical coherence tomography, Fluorescein angiography and indocyanine green angiography at the final follow-up. Fundus photograph (A), optical coherence tomography (B), fluorescein angiography (C) and indocyanine green angiography (D) show a chorioretinal atrophic scar in the juxtafovea.

Reference

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