Clinical Course Following Intravitreal Bevacizumab Injection in Posterior Placoid Chorioretinitis

Hoon Han Se; Won Lim Ji

doi:10.3341/jkos.2013.54.5.829

Journal List > J Korean Ophthalmol Soc > v.54(5) > 1009690

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Se and Ji: Clinical Course Following Intravitreal Bevacizumab Injection in Posterior Placoid Chorioretinitis

Original Article

J Korean Ophthalmol Soc 2013;54(5):829-833.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.5.829

Clinical Course Following Intravitreal Bevacizumab Injection in Posterior Placoid Chorioretinitis

Hoon Han Se, MD¹, Won Lim Ji, MD, PhD^1,²

¹Department of Ophthalmology, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine¹, Chuncheon, Korea ²

²Department of Ophthalmology, Seoul Metropolitan Dongbu Hospital², Seoul, Korea

Address reprint requests to Ji Won Lim, MD, PhD Department of Ophthalmology, Seoul Metropolitan Dongbu Hospital #124 Muhak-ro, Dongdaemun-gu, Seoul 130-707, Korea Tel: 82-2-920-9178, Fax: 82-2-920-9219, E-mail: jiwoneye@hallym.or.kr

Received 15 June 20122 October 2012 Accepted 15 February 2013

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 clinical course with optical coherence tomography findings following intravitreal bevacizumab in-jection 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 pen-icillin 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.

Keywords: Chorioretinitis, Posterior placoid chorioretinitis, Spectral-domain optical coherence tomography, Syphilis

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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.

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.

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