CHOROIDAL NEOVASCULARIZATION AS A LATE COMPLICATION OF SYPHILITIC CHORIORETINITIS MANAGED WITH INTRAVITREAL AFLIBERCEPT.

Abstract

To report a rare case of choroidal neovascular membrane (CNV) developed three years after acquired syphilitic chorioretinitis successfully treated with intravitreal aflibercept. Case report. A 44-year-old woman with bilateral decreased vision and a history of syphilitic chorioretinitis 3 years prior to presentation. Her best-corrected visual acuity was <20/400 in the right eye and 20/70 in the left eye. There was no evidence of anterior chamber or vitreous inflammation. Fundoscopy revealed a fibrovascular macular lesion associated with hemorrhages in both eyes. Optical coherence tomography (OCT) and OCT angiography confirmed the diagnosis of bilateral CNV. After ruling out other systemic diseases, the diagnosis of CNV as a late complication of syphilitic chorioretinitis was established. Although treatment was not recommended in the right eye, the left eye was treated with 3 monthly intravitreal injections of aflibercept as a solo therapy. Three weeks after the last injection, the visual acuity improved to 20/25 and remained stable at the 6-month follow-up with no evidence of CNV reactivation. Choroidal neovascular membranes can occur as a late complication of syphilitic chorioretinitis. Solo treatment with intravitreal injections of the anti-vascular endothelial growth factor aflibercept effectively controlled CNV activity and improved visual acuity.