Successful treatment of choroidal neovascular membrane in retinitis pigmentosa with intravitreal bevacizumab

Abstract

We report a rare association of choroidal neovascularization (CNV) with retinitis pigmentosa and note its resolution by intravitreal injection of the anti-vascular endothelial growth factor (VEGF), bevacizumab. A classic choroidal neovascular membrane was seen in the right eye (RE) of a patient with sector retinitis pigmentosa. Bevacizumab 1.25 mg in 0.05 ml was injected intravitreally. The choroidal neovascular membrane was seen to regress following this single intravitreal bevacizumab injection with formation of a scar. CNV has very rarely been seen in association with retinitis pigmentosa. Anti-VEGF drugs have been shown to have a beneficial role in CNV with other causes; in this case their effectiveness in CNV associated with retinal dystrophies, for example retinitis pigmentosa, has been demonstrated.

Type 3 Neovascularization Associated with Retinitis Pigmentosa

“…Choroidal neovascular membrane is very rarely associated with RP. To our knowledge, only 8 cases of CNV have been described in the literature [123456]. Seven of them were type 2 CNV, 5 had a subfoveal location, and 2 a juxtafoveal location.…”

“…One case of RP with retinal angiomatous proliferation confirmed by indocyanine green angiogram has been reported in a 60-year-old woman [6]. Based on CNV therapies available at the time of their occurrence, CNVs complicating RP have been treated with laser photocoagulation [1], photodynamic therapy [3], and medical therapy [4, 5]. Intravitreal bevacizumab has been reported to be effective for choroidal neovascular membrane stabilization in patients with RP.…”

“…Intravitreal bevacizumab has been reported to be effective for choroidal neovascular membrane stabilization in patients with RP. A case of subfoveal CNV associated with RP was successfully managed with a single intravitreal bevacizumab injection [4]. However, in another report, 5 intravitreal injections were required over a 1-year period to achieve CNV stabilization, suggesting that anatomical stabilization of RP-related CNV may be difficult to achieve [5].…”

“…Retinitis pigmentosa (RP) has rarely been associated with choroidal neovascularization (CNV) [123456]. Furthermore, its association with type 3 neovascularization is even exceptional, and only 1 case of RP associated with type 3 neovascularization has been reported to date [6].…”

Spectral Domain Optical Coherence Tomography Findings in Patients with Retinitis Pigmentosa

“…The association of RP with CNV is even rarer than other dystrophies, and only 5 cases have been reported to date [31,32,33,34]. Retinal pigment epithelium changes and concomitant photoreceptor cell involvement seem to be regularly present in RP, often being associated with choriocapillaris damage [31,32,33]. Our investigation underlines the utility of SD-OCT examination not only for the diagnosis but also for a deeper study of the pathophysiology of RP.…”