title: Intravitreal aflibercept for choroidal neovascularization in ocular sarcoidosis.
abstract: OBJECTIVE
  To report a case of choroidal neovascularization (CNV) in a patient with ocular sarcoidosis treated by intravitreal aflibercept.
  
  
  METHODS
  A 27-year old man was referred to our department because of sudden visual acuity decrease (best-corrected visual acuity (BCVA) was 20/80 LE). Fundus examination showed bilateral optic disk swelling, retinal pigment epithelium changes at the posterior pole, yellowish chorioretinal lesions in the periphery, and the presence of a prominent peripapillary neovascular complex.
  
  
  RESULTS
  The clinical diagnosis was most compatible with ocular sarcoidosis, later confirmed by mediastinal lymph node biopsy. Fluorescein and indocyanine green angiography confirmed the presence of active peripapillary type 2 (classic) CNV in both eyes. Given that the exudation of the peripapillary CNV harmed the fovea, the patient underwent a single intravitreal aflibercept injection LE. One month after the treatment, LE BCVA decreased to 20/125. Spectral-domain optical coherence tomography (SD-OCT) showed complete resolution of subretinal fluid but revealed outer retinal atrophy with complete loss of the ellipsoid zone (EZ) in the macula (possibly responsible for visual acuity worsening). Six months later, LE BCVA slightly increased to 20/100, and SD-OCT showed partial recovery of the EZ in the macula. No adverse events related to the treatment were recorded during follow-up.
  
  
  CONCLUSIONS
  We report a case of CNV in a patient with ocular sarcoidosis treated with intravitreal aflibercept. In our experience, intravitreal aflibercept injection achieved morphologic resolution for sarcoid-related peripapillary CNV.
authors: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors: Lea
authors: L
authors: Querques
authors: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors: Giuseppe
authors: G
authors: Querques
authors: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors: Elisabetta
authors: E
authors: Miserocchi
authors: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors: Giulio
authors: G
authors: Modorati
authors: Department of Ophthalmology, IRCCS Ospedale San Raffaele, University Vita-Salute, Milan - Italy.
authors: Francesco
authors: F
authors: Bandello
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D040262:Receptors, Vascular Endothelial Growth Factor / Q000627:therapeutic use*; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D021701:Sentinel Lymph Node Biopsy; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D014603:Uveal Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D011993:Recombinant Fusion Proteins; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C533178:aflibercept; D040262:Receptors, Vascular Endothelial Growth Factor