Abstract

P 281

Secondary choroidal neovascularization vs. recurrence in punctate inner choroidopathy (PIC): Therapy with bevacizumab and steroids

Susanne Marx-Gross, B. M. Stoffelns, Norbert Pfeiffer
Universitäts-Augenklinik Mainz

Punctate inner choroidopathy one of the white dot syndroms is an idiopathic disease without intraocular inflammation.
PIC threatens central vision in one or both eyes. Secondary choroidal neovascularization (CNV) could cause an acute visual loss.
A 30 years old woman presents with decreased central vision, scotoma and acute metamorphopsia on the right eye. No prior diseases. Amblyopic on the left eye. Visual acuity 1.0/<0.05.
The examination of the right eye shows multiple yellowish spots at the posterior pole and one parafoveal lesion with oedema. No Bleeding. The fluorescein angiography showed a classic CNV at the edge of a scar. We performed an intravitreal therapy with 1.25 mg bevacizumab. The visual acuity increased and the metamorphopsia disappeared. After 4 Weeks the fluorescein angiography revealed a staining of macular scarring. The OCT showed a reduced retinal thickness. Because of numerous recurrences at intervals of 2 months we need 6 injections in 12 months. Always fully regression within 4 Weeks follow-up. Last time no change after bevacizumab. We supposed a recurrence of PIC (one spot nearly the CNV) and combined bevacizumab with steroids. 4 Weeks after the metamorphopsia were disappeared and the visual acuity increased.
If a leakage at the edge of a CNV-Scar in angiography occurs, we have to decide if it is a recurrence of the underlying disease PIC or if it ids a recurrence of the complication CNV especially without any bleeding. The therapy should be adjusted.

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