Sood Gitanjli, Samanta Ramanuj, Kumawat Devesh, Nishant Prateek
Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India.
Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India.
GMS Ophthalmol Cases. 2022 May 20;12:Doc12. doi: 10.3205/oc000199. eCollection 2022.
Inflammatory choroidal neovascularization (i-CNV) is an infrequent but sight-threatening complication of posterior uveitis. Although it can occur in a wide range of infectious and non-infectious uveitides, presence of simultaneous bilateral i-CNV is rare. In this report, we present a unique case of bilateral simultaneous i-CNV in a young patient of healed tubercular serpiginous-like choroiditis.
A 20-year-old male presented with recent worsening of vision in the right eye for one month. Fundus examination revealed bilateral multifocal healed choroiditis lesions with right eye tiny subfoveal hemorrhage raising the suspicion of an underlying choroidal neovascularization. Fundus fluorescein angiography and optical coherence tomography confirmed presence of choroidal neovascular membrane in both eyes.
Resolution of activity was noted in both eyes after bilateral sequential intravitreal bevacizumab injections.
Inflammatory choroidal neovascularization may be seen in patients with healed tubercular serpiginous-like choroiditis, after a long period of quiescence. Simultaneous bilateral presentation is rare but possible, requiring mandatory multimodal imaging of both eyes under high index of suspicion. Early institution of anti-vascular endothelial growth factor may salvage optimum vision in such a scenario.
炎症性脉络膜新生血管（i-CNV）是后葡萄膜炎一种少见但威胁视力的并发症。虽然它可发生于多种感染性和非感染性葡萄膜炎，但双侧同时发生i-CNV的情况罕见。在本报告中，我们介绍了一名患有已愈合的结核性匐行性脉络膜炎的年轻患者双侧同时发生i-CNV的独特病例。
一名20岁男性因右眼视力近1个月来恶化就诊。眼底检查发现双侧多灶性已愈合的脉络膜炎病灶，右眼黄斑下有微小出血，怀疑存在潜在的脉络膜新生血管。眼底荧光血管造影和光学相干断层扫描证实双眼均存在脉络膜新生血管膜。
双眼先后行玻璃体腔注射贝伐单抗后，炎症活动消退。
在已愈合的结核性匐行性脉络膜炎患者中，经过长时间静止期后可能出现炎症性脉络膜新生血管。双侧同时出现的情况罕见但有可能，在高度怀疑时需要对双眼进行强制性多模式成像。在这种情况下，早期应用抗血管内皮生长因子可能挽救最佳视力。
