title: Choroidal Neovascularization Associated with Punctate Inner Choroidopathy: Combination of Intravitreal Anti-VEGF and Systemic Immunosuppressive Therapy.
abstract: OBJECTIVE
  Choroidal neovascularization (CNV) associated with punctate inner choroidopathy (PIC) is a rare clinical entity, yet still a challenge for medical treatment. A case of a young myopic woman developing CNV secondary to unilateral PIC is presented. Clinical morphology, diagnostic procedure and follow-up are reported.
  
  
  METHODS
  A 29-year-old woman presented with multiple yellowish dots at the posterior pole. No other signs of inflammation could be seen. Angiography with fluorescein yielded hyperfluorescent signals in the affected areas with a diffuse leak, and SD-OCT showed a slightly elevated retinal pigment epithelial layer, consistent with the diagnosis of PIC. Additionally a classic CNV was observed.
  
  
  RESULTS
  Anti-inflammatory therapy with local prednisolone acetate eye drops in combination with intravitreal injection of anti-vascular endothelial growth factor (VEGF, bevacizumab) yielded an increased best-corrected visual acuity. As CNV reappeared, systemic medication with prednisone and azathioprine in combination with two further intravitreal injections of anti-VEGF stabilized CNV and increased visual acuity again.
  
  
  CONCLUSIONS
  Combined therapy of immunosuppression with intravitreal anti-VEGF injections can be considered as therapeutic strategy in the management of recurrent CNV associated with PIC.
authors.affiliation: Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Hohberger
authors.affiliation: Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Rudolph
authors.affiliation: Department of Ophthalmology and Eye Hospital, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Antonio
authors.initials: A
authors.lastname: Bergua
keywords: Choroidal neovascularization; Choroiditis; Intravitreal anti-VEGF therapy; Punctate inner choroidopathy