Combined treatment in punctate inner choroidopathy

• Main Authors: Terelak-Borys B, Zagajewska K, Jankowska-Lech I, Tesla P, Grabska-Liberek I
• Format: Article
• Language: English
• Published: Dove Medical Press 2016-09-01
• Series: Therapeutics and Clinical Risk Management
• Subjects: punctate inner choroidopathy; neovascular membrane; anti-VEGF injections; photodynamic therapy; steroids
• Online Access: https://www.dovepress.com/combined-treatment-in-punctate-inner-choroidopathy-peer-reviewed-article-TCRM

Barbara Terelak-Borys, Katarzyna Zagajewska, Irmina Jankowska-Lech, Piotr Tesla, Iwona Grabska-Liberek Department of Ophthalmology, Centre of Postgraduate Medical Education, Prof W Orlowski Clinical Hospital, Warsaw, Poland Purpose: The purpose of this study was to describe a combination treatment for choroidal neovascular (CNV) membrane, secondary to punctate inner choroidopathy (PIC).Patient and methods: A 44-year-old female patient was diagnosed with PIC complicated by the development of recurrent juxtafoveal neovascular membrane. The treatment included a sequence of monotherapy regimens: systemic steroid therapy, photodynamic therapy, and intravitreal injections of vascular endothelial growth factor (VEGF) inhibitor (anti-VEGF). Owing to the CNV membrane resistance to various types of monotherapy, a combination treatment consisting of local injections of steroid underneath the Tenon’s capsule and intravitreal anti-VEGF injections was used.Results: Systemic steroid therapy resulted in rapid local improvement with a very short remission period. No positive effects of photodynamic therapy were observed. Sequential anti-VEGF injections led to remission periods of several months. Permanent regression of CNV membrane was achieved following combined local application of steroid and intravitreal anti-VEGF injections.Conclusion: A combination treatment including steroid and anti-VEGF medication characterized by anti-inflammatory and antiangiogenic effects may be a very beneficial option for the treatment of recurrent CNV membrane as a complication of PIC. Keywords: punctate inner choroidopathy, neovascular membrane, anti-VEGF injections, photodynamic therapy, steroids