Korean J Ophthalmol.  2011 Feb;25(1):63-65. 10.3341/kjo.2011.25.1.63.

The Development of Recurrent Choroidal Neovascularization in a Patient with Choroidal Coloboma

• Lee SH
• Ahn JK
• Yu HG

• KMID: 994416
• DOI: http://doi.org/10.3341/kjo.2011.25.1.63

Abstract

We report a case of recurrent choroidal neovascularization (CNV) in an eye with chorioretinal coloboma. A 36-year-old woman presented complaining of decreased visual acuity (VA) in her left eye. Best corrected visual acuity (BCVA) was 20/200 and iris coloboma was observed. Funduscopy and fluorescein angiography (FA) showed CNV in the superior extrafoveal region with chorioretinal coloboma reaching just inferior to the optic disc. No other cause for CNV was observed except for the chorioretinal coloboma. BCVA improved to 20/30 after laser photocoagulation. She revisited our clinic for deteriorating VA (20/400) in the same eye 3 years after treatment. Funduscopy and FA demonstrated recurrent CNV with subfoveal hemorrhage. Photodynamic therapy (PDT) was followed by three consecutive intravitreal bevacizumab injections (IVB) for the subfoveally-located CNV. However, the CNV persisted with the appearance of a fresh subretinal hemorrhage. Additional PDT was combined with IVB on the same day 6 months after the initial PDT. The CNV regressed 3 months after treatment and has not recurred as of 8 months after the last treatment. The patient's BCVA improved to 20/60. This case suggests that PDT combined with IVB can be an alternative treatment for the management of recurrent CNV after laser photocoagulation in eyes with chorioretinal coloboma.

Keyword

Bevacizumab; Choroidal coloboma; Choroidal neovascularization; Photochemotherapy

MeSH Terms

Adult
Angiogenesis Inhibitors/administration & dosage
Antibodies, Monoclonal/administration & dosage
Choroid Diseases/*complications/drug therapy/surgery
Choroidal Neovascularization/diagnosis/*etiology/physiopathology
Coloboma/*complications/drug therapy/surgery
Female
Fluorescein Angiography
Fundus Oculi
Humans
Intravitreal Injections
Laser Coagulation
Photochemotherapy
Recurrence
Visual Acuity

Figure

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  Fig. 1 (A) Fundus photograph and fluorescein angiography showing an inferior choroidal coloboma with choroidal neovascularization and subretinal hemorrhage. (B) Fundus photograph and fluorescein angiography showing recurrent choroidal neovascularization around the previous laser scar.

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  Fig. 2 (A) Fundus photograph demonstrating the inferior choroidal coloboma with choroidal neovascularization (CNV), subretinal hemorrhage (SRH), and laser photocoagulation scarring. (B) Fluorescein angiography (late phase) showing hyperfluorescence from CNV. (C) Fundus photograph showing newly-developed SRH and CNV. (D) Fundus photograph showing fibrotic CNV scarring. (E) Vertically scanned image of Stratus OCT showing subretinal fluid (arrow). (F) Vertically scanned image of Cirrus OCT demonstrating resolution of the subretinal fluid.

Reference

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