Visual and Optical Coherence Tomography Outcomes of Intravitreal Bevacizumab and Ranibizumab in Inflammatory Choroidal Neovascularization Secondary to Punctate Inner Choroidopathy

Abstract

Choroidal neovascular membranes (CNV) are the major cause of visual loss in punctate inner choroidopathy (PIC), an idiopathic inflammatory condition predominantly affecting young, myopic women. We present a case series of 9 patients with CNV associated with PIC, treated with intravitreal anti-vascular endothelial growth factor agents. This is a retrospective case series of 9 patients treated with either intravitreal bevacizumab or ranibizumab for inflammatory CNV secondary to PIC. Initial and posttreatment converted logMAR visual acuity, fundus fluorescein angiograms (FFA), optical coherence tomography (OCT), previous and concurrent treatments, and side effects were recorded. Informed consent for treatment was obtained from each patient. Nine patients (8 female, 1 male) with an average age of 34.4 years were treated for an average of 14.9 months. Six patients were treated with bevacizumab, and 3 with ranibizumab, with a mean of 2.34 injections per year. The mean visual acuity gain for the whole group of 9 patients was 0.26 converted logMAR units (Wilcoxon signed-rank test, p<0.015). Eight patients remained stable or had visual improvement at final follow-up, with a mean gain of 0.36 converted logMAR units. Only one patient's vision deteriorated (loss of 0.48 converted logMAR units). Concomitant short courses of oral corticosteroid were used in 3 of the 9 patients. Over a 1-year period, bevacizumab and ranibizumab can be safely and successfully used to treat inflammatory CNV secondary to PIC, avoiding the need for systemic immunosuppression in the majority of patients.