title: Rescue therapy with intravitreal aflibercept for choroidal neovascularization secondary to choroidal osteoma non-responder to intravitreal bevacizumab and ranibizumab.
abstract: To investigate the effect of aflibercept in a rare case of choroidal neovascularization (CNV) secondary to choroidal osteoma (CO) and refractory to ranibizumab and bevacizumab. A 45-year-old male with CO-related CNV in his left eye received prior two intravitreal 1.25 mg bevacizumab injections and three intravitreal 0.5 mg ranibizumab injections without visual and anatomic improvement. Best-corrected visual acuity assessment, ophthalmic examination, fundus photography, and optical coherence tomography (OCT) were performed. Switching to intravitreal injection of 2.0 mg aflibercept was performed. After three loading doses of intravitreal aflibercept, visual acuity of the left eye improved from 20/50 to 20/32. Resolution of the persistent subfoveal fluid and reduction of retinal hemorrhage were confirmed according to ophthalmoscopy and OCT findings. No serious adverse events were observed. The treatment effect persisted during a 10-month follow-up period. In choroidal osteoma, switching to intravitreal aflibercept injection may be an effective therapeutic option for treatment of CNV refractory to ranibizumab and bevacizumab.
authors.affiliation: Ophthalmology Department, Polytechnic University of Marche, Via Conca 71, 60020, Ancona, Italy, andrea@dottorsaitta.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Saitta
authors.forename: Michele
authors.initials: M
authors.lastname: Nicolai
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Neri
authors.forename: Michele
authors.initials: M
authors.lastname: Reibaldi
authors.forename: Alfonso
authors.initials: A
authors.lastname: Giovannini
authors.forename: Cesare
authors.initials: C
authors.lastname: Mariotti
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000008:administration & dosage*; D002830:Choroid Neoplasms / Q000150:complications*; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D057915:Drug Substitution; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000008:administration & dosage*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000008:administration & dosage*; D011993:Recombinant Fusion Proteins / Q000008:administration & dosage*
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C533178:aflibercept; D000068258:Bevacizumab; D040262:Receptors, Vascular Endothelial Growth Factor; D000069579:Ranibizumab