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Successful treatment of choroidal neovascularization secondary to persistent placoid maculopathy with intravitreal bevacizumab.

PURPOSE
To report a case of posterior placoid maculopathy with secondary choroidal neovascularization that responded favorably to repeat intravitreal injections of bevacizumab with long-term follow-up.


METHODS
Patient data from all clinic visits were reviewed. These include visual acuity measurements and clinical examination findings, optical coherence tomography, color fundus photography, and fluorescein angiography images from the initial visit and follow-up encounters.


RESULTS
This patient showed clear evidence of active leakage from choroidal neovascularization on presentation that promptly resolved with treatment. After his initial course of injections, all evidence of active exudation disappeared from his optical coherence tomography scans. However, when treatment was extended beyond 8 weeks, choroidal neovascularization leakage returned. In addition, the patient developed subretinal fibrosis in one eye despite regular treatments. Nevertheless, visual acuity has remained excellent through his most recent encounter.


CONCLUSION
Persistent placoid maculopathy is an exceedingly rare clinical entity. In their original descriptive series, Golchet et al revealed that 9 of the 12 eyes went on to develop poor vision from complications of choroidal neovascularization. There is currently only one case in the literature that describes the use of anti-vascular endothelial growth factor medications in the treatment of persistent placoid maculopathy with promising results. This case adds supporting evidence for this treatment modality and highlights the need for continued follow-up and treatment till 18 months from presentation.