Intravitreal Aflibercept as an Adjunct to Systemic Therapy in a Case of Choroidal Neovascular Membrane Associated with Sympathetic Ophthalmia

Abstract

Choroidal neovascular membrane (CNV) is a very rare complication in patients with sympathetic ophthalmia. We hereby report a 38-year-old man who developed a type 2 CNV in his only seeing (left) eye while under systemic steroid treatment. Systemic therapy was revised and a total of 5 intravitreal aflibercept injections (2 mg each) were administered over a period of 8 months. Good anatomic and functional outcome was noted at the last visit. Anti-vascular endothelial growth factor injection may be an important adjunct to systemic therapy in eyes with with sympathetic ophthalmia-associated CNV.

Favorable clinical outcome with intravitreal aflibercept treatment in a case with bilateral choroidal neovascular membrane and quiescent Vogt-Koyanagi-Harada syndrome

“…Steroids and immunosuppressives are often used in uveitis to reduce the inflammatory stimulus which seems to play a role in CNV formation, and also partly due to their antiangiogenic effect [ 8 ]. However, locally targeted therapy is often administered to treat the CNV in order to achieve an anatomically and visually superior outcome [ 1 ], [ 9 ], [ 10 ].…”

Sympathetic ophthalmia: A comprehensive update

“…Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are useful adjuncts in eyes with sympathetic ophthalmia complicated by choroidal neovascularization (CNV). [ 72 ] While there are few reports of such complications, the use of optical coherence tomography angiography can help in detecting such membranes in future, thereby expanding the spectrum of patients who require anti-VEGF therapy. There is no preference among ranibizumab, bevacizumab, or aflibercept for treating inflammatory CNV in eyes with sympathetic ophthalmia.…”

Sympathetic Ophthalmia: Where Do We Currently Stand on Treatment Strategies?

“…In the chronic phase of the SO, the most common presentation is panuveitis or anterior uveitis with extensive chorioretinal damage. Subretinal fibrosis ( Figure 3 ) and choroidal neovascularization 90 may be noted in chronic cases. Depigmentation of the choroid in pigmented individuals and the appearance of multiple nummular chorioretinal scars located mostly in the periphery of the fundus are seen.…”

“…Saatci et al 90 successfully used intravitreal aflibercept as an adjunct to systemic therapy in the case of choroidal neovascular membrane associated with SO.…”