title: Combined treatment in punctate inner choroidopathy.
abstract: OBJECTIVE
  The purpose of this study was to describe a combination treatment for choroidal neovascular (CNV) membrane, secondary to punctate inner choroidopathy (PIC).
  
  
  METHODS
  A 44-year-old female patient was diagnosed with PIC complicated by the development of recurrent juxtafoveal neovascular membrane. The treatment included a sequence of monotherapy regimens: systemic steroid therapy, photodynamic therapy, and intravitreal injections of vascular endothelial growth factor (VEGF) inhibitor (anti-VEGF). Owing to the CNV membrane resistance to various types of monotherapy, a combination treatment consisting of local injections of steroid underneath the Tenon's capsule and intravitreal anti-VEGF injections was used.
  
  
  RESULTS
  Systemic steroid therapy resulted in rapid local improvement with a very short remission period. No positive effects of photodynamic therapy were observed. Sequential anti-VEGF injections led to remission periods of several months. Permanent regression of CNV membrane was achieved following combined local application of steroid and intravitreal anti-VEGF injections.
  
  
  CONCLUSIONS
  A combination treatment including steroid and anti-VEGF medication characterized by anti-inflammatory and antiangiogenic effects may be a very beneficial option for the treatment of recurrent CNV membrane as a complication of PIC.
authors.affiliation: Department of Ophthalmology, Centre of Postgraduate Medical Education, Prof W Orlowski Clinical Hospital, Warsaw, Poland.
authors.forename: Barbara
authors.initials: B
authors.lastname: Terelak-Borys
authors.affiliation: Department of Ophthalmology, Centre of Postgraduate Medical Education, Prof W Orlowski Clinical Hospital, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Zagajewska
authors.affiliation: Department of Ophthalmology, Centre of Postgraduate Medical Education, Prof W Orlowski Clinical Hospital, Warsaw, Poland.
authors.forename: Irmina
authors.initials: I
authors.lastname: Jankowska-Lech
authors.affiliation: Department of Ophthalmology, Centre of Postgraduate Medical Education, Prof W Orlowski Clinical Hospital, Warsaw, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Tesla
authors.affiliation: Department of Ophthalmology, Centre of Postgraduate Medical Education, Prof W Orlowski Clinical Hospital, Warsaw, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Grabska-Liberek
keywords: anti-VEGF injections; neovascular membrane; photodynamic therapy; punctate inner choroidopathy; steroids