Management of an inflammatory choroidal neovascular membrane in Vogt-Koyanagi-Harada syndrome: a case report

Author: Sandra Gómez Perera (Spain)

Co-authors: Hugo E. Tapia Quijada, Rocío Falcón Roca, Carla Arteaga Henríquez

Purpose

Choroidal neovascularization in patients with Vogt-Koyanagi-Harada disease is a rare complication, occurring in around 10% of patients. They are produced by sustained inflammation but also by choroidal ischemia and it usually have a good response to antiangiogenic treatment.

Setting/Venue

Retina section of the University Hospital of the Canary Islands-Spain

Methods

We present the case of a 19-year-old male patient from Cuba who presented with bilateral panuveitis three years earlier and developed a neovascular membrane (NVM).

Results

During the development of his disease, in his country of origin, 3 doses of Avastin were prescribed in a period of 11 for macular edema 2nd to NVM with good response and as basic treatment he was on a reducing regimen of prednisone 5 mg per day. He presented worsening of visual acuity with associated metamorphopsia in the LE, so he himself decided to increase the corticosteroid to 10 mg and consult after two days. The VA recorded was 1 in RE and 0.2 in LE. The optical coherence tomography (OCT) revealed macular edema with NVM present and adjacent to it, a small amount of RSL between the Bruch - Interdigitation Zone / Ellipsoid complex. It was decided to prescribe intravitreal Lucentis and an evolution was recorded with OCT.

Conlusions

The response of choroidal neovascularization to antiangiogenic therapy has been well studied and is effective in these patients. In this case, 15 months after the last injection, the patient reactivates, so new ones are prescribed and the response has been recorded with OCT.

Financial Disclosure

No financial disclosure statement