ABSTRACT
BACKGROUND: Multifocal choroiditis (MFC) is an inflammatory condition, occasionally associated with choroidal neovascularization (CNV). Bevacizumab (Avastin) and ranibizumab (Lucentis) are therapies that target vascular endothelial growth factor. Bevacizumab and ranibizumab have been used successfully to treat CNV in age-related and myopic macular degeneration. PURPOSE: : To describe the treatment of MFC-associated CNV with intravitreal bevacizumab and/or ranibizumab. DESIGN: Retrospective interventional case series. PARTICIPANTS: Six eyes of five patients with MFC-associated CNV were treated with intravitreal bevacizumab and/or ranibizumab. MAIN OUTCOME MEASURES: Visual acuity at 1, 3, and 6 months after the initial injection. RESULTS: Previous therapies (number of eyes treated) included sub-Tenon's corticosteroids (2), intravitreal corticosteroids (1), photodynamic therapy (1), and thermal laser (1). The mean number (range) of antivascular endothelial growth factor injections per eye was 2.3 (1-6). The mean duration (range) of follow-up per patient was 41.5 (25-69) weeks. Five of six eyes improved to 20/30 acuity or better at 6 months. One eye suffered a subfoveal rip of the retinal pigment epithelium with 20/400 acuity. There was a qualitative decrease in clinical and angiographic evidence of CNV. CONCLUSIONS: Bevacizumab and ranibizumab were effective at improving visual acuity over 6 months in a small series of patients with MFC-associated CNV. Tears of the retinal pigment epithelium may occur after intravitreal antivascular endothelial growth factor therapy in MFC-associated CNV.
Subject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Choroidal Neovascularization/drug therapy , Choroiditis/drug therapy , Adult , Antibodies, Monoclonal, Humanized , Bevacizumab , Choroidal Neovascularization/etiology , Choroiditis/complications , Drug Therapy, Combination , Female , Fluorescein Angiography , Follow-Up Studies , Humans , Injections , Male , Middle Aged , Ranibizumab , Retrospective Studies , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity , Vitreous BodyABSTRACT
PURPOSE: We report spectral domain optical coherence tomography findings of the peripheral retina in a patient with senile (acquired) retinoschisis. METHODS: This is an observational case report. Spectral domain optical coherence tomography was performed to image the peripheral retina at the area of retinoschisis in a 70-year-old man with bilateral inferonasal elevated peripheral retinal lesions. Since the lesions were not entirely transparent and smooth, and demonstrated a certain degree of mobility, the diagnosis of retinal detachment could not be excluded. RESULTS: Spectral domain optical coherence tomography scans obtained at the margin of the lesions demonstrated attached retina with a characteristic splitting of the neurosensory retina at the outer plexiform layer and cystic changes in the inner retina. CONCLUSIONS: Spectral domain optical coherence tomography can assist in the diagnosis of senile (acquired) retinoschisis, particularly in cases where retinal detachment cannot be excluded on clinical examination alone.
Subject(s)
Retina/pathology , Retinoschisis/diagnosis , Tomography, Optical Coherence , Aged , Functional Laterality , Humans , Male , Retinal Detachment/diagnosisABSTRACT
PURPOSE: To describe multifocal choroiditis in two siblings. METHODS: Retrospective case reports. RESULTS: Two sisters presented 10 years apart with multifocal choroiditis. The first sister manifested late findings of multiple punched-out chorioretinal lesions and a quiescent central fibrovascular scar. The second sister presented in the acute phase with multiple creamy yellow lesions near the optic nerve and fovea and with a choroidal neovascular membrane. Both cases were unilateral. DISCUSSION: Multifocal choroiditis is an inflammatory disorder of the inner choroid and retinal pigment epithelium of unknown etiology. There is no gene associated with multifocal choroiditis, and to our knowledge, no cases of relatives with the disease have been reported. CONCLUSION: We describe multifocal choroiditis in two sisters, suggesting a possible genetic or environmental component to this disease. Further study is necessary to better elucidate the etiology of this disease.