J Korean Ophthalmol Soc.  2013 May;54(5):829-833. 10.3341/jkos.2013.54.5.829.

Clinical Course Following Intravitreal Bevacizumab Injection in Posterior Placoid Chorioretinitis

• Han SH
• Lim JW

• KMID: 2217055
• DOI: http://doi.org/10.3341/jkos.2013.54.5.829

Abstract

PURPOSE
To report the clinical course with optical coherence tomography findings following intravitreal bevacizumab injection in patients with posterior placoid chorioretinitis due to latent syphilis.
CASE SUMMARY
A 43-year-old woman presented with visual dimness in the right eye 3 days in duration. Fundus examination showed yellow, placoid lesions in the right eye and there was no cell reaction in the anterior chamber and vitreous. An intravitreal bevacizumab injection was given and systemic work-up performed. After 1 week, the macular lesion disappeared. However, photoreceptor disarrangement was present on spectral-domain optical coherence tomography image. On serologic test, the Venereal Disease Research Laboratory test, and fluorescent treponemal antigen absorption test were positive. She was referred to a division of infectious diseases and confirmed as latent syphilis. The patient received intramuscular penicillin 3 times weekly. Visual acuity and outer retinal abnormality further improved and there was no recurrence during the 6-month follow-up.
CONCLUSIONS
Intravitreal bevacizumab injection added to antibiotic treatment may be considered for treating patients with posterior placoid chorioretinitis. Further studies are necessary to evaluate precise disease mechanisms and treatment.

Keyword

Chorioretinitis; Posterior placoid chorioretinitis; Spectral-domain optical coherence tomography; Syphilis

MeSH Terms

Absorption
Anterior Chamber
Antibodies, Monoclonal, Humanized
Chorioretinitis
Communicable Diseases
Eye
Female
Humans
Penicillins
Recurrence
Retinaldehyde
Serologic Tests
Sexually Transmitted Diseases
Syphilis
Syphilis, Latent
Tomography, Optical Coherence
Visual Acuity
Bevacizumab
Antibodies, Monoclonal, Humanized
Penicillins
Retinaldehyde

Figure

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  Figure 1. (A) Initial fundus photography of right eye. It showed yellow-white placoid lesion with a retinal hemorrhage in the macula (B) Late-phase of fluorescein angiography. It revealed a lesion of with well-defined borders and late-staining hyperfluorescence.

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  Figure 2. Horizontal section of spectral-domain optical coher-ence tomography images (A) Image at initial visit using en-hanced-depth image mode. An ill-defined photoreceptor in-ner/outer segment junction and absent external limiting mem-brane were shown. There was hypodensity area arounding an irregular hyperdensity infiltration on outer retina. Choroidal detail revealed irregular, diffuse infiltration of the inner cho-roidal vasculature. (B) Image at 1 week after intravitreal bevacizumab. The hypodensity area was disappeared and pho-toreceptor disarrangement was remained. (C) Image after 1 month after intravitreal bevacizumab injection using en-hanced-depth image mode. Restored stratification of the outer retinal layers and well-defined numerous choroidal vascular space were shown.

Reference

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