title: Two cases of subfoveal choroidal neovascularization with tubulointerstitial nephritis and uveitis syndrome.
abstract: OBJECTIVE
  Tubulointerstitial nephritis and uveitis (TINU) syndrome usually shows anterior segment intraocular inflammation, but severe posterior segment intraocular inflammation is rarely observed. We report 2 children with TINU syndrome complicated by subfoveal choroidal neovascularization (CNV).
  
  
  METHODS
  Case reports.
  
  
  RESULTS
  Patients were a 12-year-old girl and a 12-year-old boy diagnosed with probable TINU syndrome on the basis of typical ocular findings and high value of urinary β2 microglobulin even though renal biopsy was not performed. The girl showed development of CNV with subretinal macular hemorrhage along with the exacerbation of anterior chamber inflammation in her left eye. Subretinal macular hemorrhage recurred frequently even with oral prednisolone; therefore, intravitreal injection of bevacizumab (IVB) was performed. After IVB, the subretinal proliferative tissue shrunk and subretinal hemorrhage has not recurred for 5 years. The boy showed subretinal hemorrhage from CNV with severe anterior chamber inflammation in his left eye. With oral prednisolone, anterior chamber inflammation and subretinal hemorrhage disappeared, but shrunken subretinal fibrosis in the macula remained. Final visual acuity was poor due to residual subretinal fibrosis in both cases.
  
  
  CONCLUSIONS
  Tubulointerstitial nephritis and uveitis syndrome has a potential to develop CNV that leads to severe visual loss; therefore, prompt anti-inflammatory therapy is required, and IVB should be regarded as a potential choice of treatment.
authors: Department of Ophthalmology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors: Yuko
authors: Y
authors: Takemoto
authors: Kenichi
authors: K
authors: Namba
authors: Kazuomi
authors: K
authors: Mizuuchi
authors: Shigeaki
authors: S
authors: Ohno
authors: Susumu
authors: S
authors: Ishida
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D002648:Child; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005451:Fluorescein Angiography; D005584:Fovea Centralis; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009395:Nephritis, Interstitial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D041623:Tomography, Optical Coherence; D014605:Uveitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D011239:Prednisolone