Peripapillary subretinal neovascularization in sarcoidosis: remission and exacerbation during oral corticosteroid therapy.
BACKGROUND
In sarcoidosis, peripapillary subretinal neovascularization is rare. The role of corticosteroid therapy for subretinal neovascularization is controversial.


METHODS
A 38-year-old female patient weighing 38 kg with histologically diagnosed sarcoidosis presented with peripapillary subretinal neovascularization, retinal phlebitis, a hyperemic disc, and snowball vitreous opacities in the left eye.


METHODS
Oral betamethasone therapy at an initial dose of 3 mg/day reduced the size of subretinal neovascular membrane, and the membrane became fibrous. Despite the total initial 140 mg of betamethasone given over 2.5 months and the additional total 700 mg of prednisolone given over the next 2 months, the subretinal neovascularization recurred. Six months after the first recurrence, a second recurrence developed during the tapering-off period of oral corticosteroid therapy. At the second recurrence, the oral corticosteroid therapy was ineffective in reducing the size of the neovascular membrane.


CONCLUSIONS
In our patient, oral corticosteroids temporarily suppressed peripapillary subretinal neovascularization but failed to prevent extension of neovascular membrane to the fovea because of recurrent sarcoidosis. Over time, oral corticosteroids appear to lose their effectiveness for treating repeated recurrence of peripapillary subretinal neovascularization associated with sarcoidosis.
Abe
Koji
K
Department of Ophthalmology, Osaka City University Medical School, Osaka, Japan.
Shiraki
Kunihiko
K
Yasunari
Takaharu
T
Kohno
Takeya
T
Miki
Tokuhiko
T
D000284:Administration, Oral; D000328:Adult; D001623:Betamethasone / Q000627:therapeutic use; D005260:Female; D005451:Fluorescein Angiography; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007208:Indocyanine Green; D009898:Optic Disk / Q000098:blood supply*; D011239:Prednisolone / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D015861:Retinal Neovascularization / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D005938:Glucocorticoids; C009022:prednisolone phosphate; D001623:Betamethasone; D011239:Prednisolone; D007208:Indocyanine Green