Regression of Choroidal Neovascularization in a Choroideremia Patient after Intravitreal Bevacizumab Injection: A Case Report

Deok Bae Kim; Mu O Jung; Sung Won Cho; Gwang Ju Choi

doi:10.3341/jkos.2011.52.6.742

Journal List > J Korean Ophthalmol Soc > v.52(6) > 1009068

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Kim, Jung, Cho, and Choi: Regression of Choroidal Neovascularization in a Choroideremia Patient after Intravitreal Bevacizumab Injection: A Case Report

Original Article

J Korean Ophthalmol Soc 2011;52(6):742-745.

Published online: 31 August 2011

DOI: https://doi.org/10.3341/jkos.2011.52.6.742

Regression of Choroidal Neovascularization in a Choroideremia Patient after Intravitreal Bevacizumab Injection: A Case Report

Deok Bae Kim, MD¹, Mu O Jung, MD², Sung Won Cho, MD, PhD³, Gwang Ju Choi, MD, PhD²

¹Happy Eye Clinic, Gwangju, Korea

²Department of Ophthalmology, School of Medicine, Chosun University, Gwangju, Korea

³Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University, Daejeon, Korea

Address reprint requests to Dae Hyun Kim, MD, PhD, Department of Ophthalmology, Chosun University Hospital #588 Seoseok-dong, Dong-gu, Gwangju 501-717, Korea Tel: 82-62-220-3190, Fax: 82-62-225-9839, E-mail: eyelovehyun@hanmail.net

Received 27 August 2010 Revised 14 December 2010 Accepted 22 March 2011

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To report the first domestic case of choroidal neovascularization in a choroideremia patient treated with intra-vitreal bevacizumab injection.

Case summary

A 29-year-old male presented with a sudden decline in vision in the left eye. Fundus examination revealed areas of choriocapillaries and retinal pigment epithelium atrophy with macular hemorrhage. Fluorescein angiogram revealed vascular hyperfluorescence in the juxtafoveal area. Neurosensory detachment around the macula and increased central macular thickness was also observed using optical coherence tomography. Upon the diagnosis of choroideremia with choroidal neovascularization, the patient was treated with 1.25 mg intravitreal bevacizumab. Visual acuity improved after four injections of intravitreal Bevacizumab with improvement in both detachment and fluorescein leakage.

Conclusions

In patients with choroideremia presenting sudden decline in vision, ophthalmologists should detect for possible choroidal neovascularization. The results from the present study show that judicious use of intravitreal Bevacizumab may be effective in such cases. Further studies with a large sample size and sufficiently long follow-up periods are required.

Keywords: Bevacizumab, Choroideremia, Neovascularization

References

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Figure 1.

Fundus photographs of right eye (A) and left eye (B) at presentation show areas of choriocapillaries and retinal pigment epithelium atrophy in the mid-periphery and posterior pole relatively sparing the macula. Note the macular hemorrhage in the left eye (B). Fluorescein angiogram of right eye (C) and left eye (D) at presentation show symmetrical areas of retinal pigment epithelium and choriocapillary loss. The fovea is spared with surrounding areas of hyperfluorescence. Note the leakage from a juxtafo-veal choroidal neovascularization (CNV) in the left eye (D).

Figure 2.

The optical coherence tomographs (OCT) of the patient's left eye at initial visit shows increased central retinal thickness owing to neurosensory detachment and shallow elevation of the pigmented epithelium.

Figure 3.

Fluorescein angiogram of the left eye after 3 intravitreal bevacizumab injections shows leakage in the newly developed juxtafoveal choroidal neovascularization (CNV) just above the previous lesion.

Figure 4.

Fluorescein angiogram (A) 2 months after the 4th intravitreal bevacizumab injection shows complete leakage resolution. OCT (optical coherence tomographs) image (B) also shows resolved detachment and marked decrease of central retinal thickness.

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