Evaluation of Idiopathic Choroidal Neovascularization with Indocyanine Green Angiography in Patients Undergoing Bevacizumab Therapy

BILATERAL PERIPAPILLARY CHOROIDAL NEOVASCULARIZATION IN AN OTHERWISE HEALTHY TEENAGER TREATED WITH ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR INJECTIONS

PURPOSE

This case report describes the presentation, diagnostic reasoning, and successful management of a 14-year-old teenage boy found to have bilateral peripapillary choroidal neovascularization.

METHODS

This is a case of a teenage boy with an unremarkable ocular and systemic history presenting with decreased visual acuity, macular edema, and bilateral peripapillary choroidal neovascularization.

RESULTS

After intravitreal antivascular endothelial growth factor injections, the patient's visual acuity improved. Imaging further revealed that the initially present macular edema, subretinal fluid, and peripapillary choroidal neovascularizations markedly improved after treatment.

CONCLUSION

Peripapillary choroidal neovascularizations are often not trivial to diagnose. As this report illustrates, work-up with different modalities is extremely valuable, and antivascular endothelial growth factor injections may help decrease exudation and improve visual outcomes.

An update on inflammatory choroidal neovascularization: epidemiology, multimodal imaging, and management

Inflammatory choroidal neovascular membranes are challenging to diagnose and manage. A number of uveitic entities may be complicated by the development of choroidal neovascularization leading to a decrease in central visual acuity. In conditions such as punctate inner choroidopathy, development of choroidal neovascularization is extremely common and must be suspected in all cases. On the other hand, in patients with conditions such as serpiginous choroiditis, and multifocal choroiditis, it may be difficult to differentiate between inflammatory choroiditis lesions and choroidal neovascularization. Multimodal imaging analysis, including the recently introduced technology of optical coherence tomography angiography, greatly aid in the diagnosis and management of inflammatory choroidal neovascularization. Management of these neovascular membranes consists of anti-vascular growth factor agents, with or without concomitant anti-inflammatory and/or corticosteroid therapy.