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

Hyun Woong Kim; Yong Wun Cho; In Young Chung

doi:10.3341/jkos.2016.57.3.513

Journal List > J Korean Ophthalmol Soc > v.57(3) > 1010542

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Kim, Cho, and Chung: Management of Relapsed Inflammatory Choroidal Neovascularization in Punctate Inner Choroidopathy after Bevacizumab

Case Report

J Korean Ophthalmol Soc 2016;57(3):513-517.

Published online: 3 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.3.513

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

Hyun Woong Kim, MD, PhD¹, Yong Wun Cho, MD², In Young Chung, MD, PhD²

¹Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine1, Busan, Korea

²Department of Ophthalmology, Gyeongsang National University School of Medicine², Jinju, Korea

Address reprint requests to In Young Chung, MD, PhD, Department of Ophthalmology, Gyeongsang National University Hospital, #79 Gangnam-ro, Jinju 52727, Korea, Tel: 82-55-750-8728, Fax: 82-55-758-4158, E-mail: inyoung@gnu.ac.kr

Received 30 December 2015 Revised 30 December 2015 Accepted 13 February 2016

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 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.

Keywords: Bevacizumab, Choroidal neovascularization, Punctuate inner choroidopathy

References

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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.

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.

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.

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