Peripapillary choroidal neovascularization in pars planitis
1 Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, 30307, USA
2 Ocular Inflammation Service, Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania, Philadelphia, PA, 19104, USA
3 Retina Service, Wills Eye Institute, Philadelphia, PA, 19107, USA
4 Department of Biostatistics & Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
5 Center for Preventative Ophthalmology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, 3535 Market St., Suite 700, Philadelphia, PA, 19104, USA
Journal of Ophthalmic Inflammation and Infection 2013, 3:13 doi:10.1186/1869-5760-3-13Published: 15 January 2013
Choroidal neovascularization (CNV) is a rare complication of intermediate uveitis. Risk factors are not well-characterized. Here, we describe a case of peripapillary CNV in a patient with intermediate uveitis and explore the pathophysiology and treatment of this condition. This study is a case report and review of the literature.
A 15-year-old boy with intermediate uveitis - suppressed for the preceding year on immunosuppressive therapy and low-dose corticosteroids - and chronic disc swelling presented with unilateral metamorphopsia, peripapillary subretinal hemorrhage, and subretinal fluid. Fluorescein angiogram confirmed the presence of an active choroidal neovascular membrane. Treatment with intravitreal bevacizumab 1.25 mg every 4 weeks for 4 months resulted in resolution of subretinal fluid, subretinal hemorrhage, and regression of the CNV. The patient's intermediate uveitis remained inactive throughout this time.
Review of the existing literature and pathophysiologic consideration suggests that chronic disc edema may be a risk factor for this condition. Peripapillary CNV in the context of intermediate uveitis appears to respond well to VEGF-inhibitor therapy.