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2015 ; 6
(3
): 385-9
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English Wikipedia
Choroidal Neovascularization Associated with Punctate Inner Choroidopathy:
Combination of Intravitreal Anti-VEGF and Systemic Immunosuppressive Therapy
#MMPMID26955337
Hohberger B
; Rudolph M
; Bergua A
Case Rep Ophthalmol
2015[Sep]; 6
(3
): 385-9
PMID26955337
show ga
PURPOSE: Choroidal neovascularization (CNV) associated with punctate inner
choroidopathy (PIC) is a rare clinical entity, yet still a challenge for medical
treatment. A case of a young myopic woman developing CNV secondary to unilateral
PIC is presented. Clinical morphology, diagnostic procedure and follow-up are
reported. CASE REPORT: A 29-year-old woman presented with multiple yellowish dots
at the posterior pole. No other signs of inflammation could be seen. Angiography
with fluorescein yielded hyperfluorescent signals in the affected areas with a
diffuse leak, and SD-OCT showed a slightly elevated retinal pigment epithelial
layer, consistent with the diagnosis of PIC. Additionally a classic CNV was
observed. RESULTS: Anti-inflammatory therapy with local prednisolone acetate eye
drops in combination with intravitreal injection of anti-vascular endothelial
growth factor (VEGF, bevacizumab) yielded an increased best-corrected visual
acuity. As CNV reappeared, systemic medication with prednisone and azathioprine
in combination with two further intravitreal injections of anti-VEGF stabilized
CNV and increased visual acuity again. CONCLUSION: Combined therapy of
immunosuppression with intravitreal anti-VEGF injections can be considered as
therapeutic strategy in the management of recurrent CNV associated with PIC.