Photodynamic therapy following intravitreal bevacizumab in multifocal choroiditis

Purpose To report the use of intravitreal bevacizumab (avastin) followed by photodynamic therapy (PDT) in a case of choroidal neovascular membrane (CNVM) due to multifocal choroiditis. Design Interventional case report. Methods In the setting of institutional practice, a 40-year male patient with previously diagnosed multifocal choroiditis presented with reduced vision in his left eye. A CNVM was revealed through hazy vitreous in the left eye. Due to a prior episode of increased intraocular pressure with use of periocular steroid (triamcinolone), and marked vitreous haze precluding precise assessment of the neovascular membrane, intravitreal injection of bevacizumab was tried followed by PDT. Results There was clearing of the vitreous haze and reduction of leakage one week after intravitreal injection. PDT one month after injection resulted in stable vision at three-month follow-up without angiographic leakage. Conclusion Intravitreal bevacizumab may be tried in cases of CNVM due to multifocal choroiditis. Timing of the injection may vary with the clinical scenario.