Abstract

Volume.116 Number.2

Original article : Case report

A Patient with Recurrent Central Serous Chorioretinopathy who Developed Multiple Evanescent White Dots and Serous Retinal Detachment Immediately Following Bevacizumab Administration
Satoh Shoko1, Miyagawa Yasuhiro1,2, Mori Taiko1,2
1 Department of Ophthalmology, Odate Municipal Hospital
2 Depertment of Ophthalmology, Hirosaki University Graduate School of Medicine

Background: A patient developed choroidal neovascularization (CNV) in one eye during treatment for bilateral recurrent central serous chorioretinopathy (CSC) and was intravitreously injected with bevacizumab; she developed multiple evanescent white dots and serous retinal detachment (SRD).
Case: A 50-year-old women had a history of CSC OD at the age of 29 years. On initial examination, CSC OD was noted, and multiple detachments of the retinal pigment epithelium OU were observed. While the CSC in the right eye was successfully treated by laser photocoagulation, it spread to both eyes following this episode. Examination of the right eye by optical coherence tomography (OCT) following the recurrence of the CSC showed slight elevation of the retinal pigment epithelial layer in the central fovea, but this finding disappeared with the resolution of the CSC. However, as the CSC combined with CNV (Gass type 2) recurred within 1 year, the patient was intravitreously injected with bevacizumab. On the day following the injection, SRD OD occurred, and on the 7th day following the injection many white lesions varying in size appeared in the deep layer of the retina, but they healed 3 weeks later, leaving only the CNV. The CNV was cured later by additional photodynamic therapy.
Conclusion: Since the lesions of the fundus observed immediately after the bevacizumab administration resolved spontaneously without sequelae, they were retrospectively diagnosed as a white dot syndrome-like disease. The white dot syndrome-like disease is suggested as a rare complication of bevacizumab.

Key words
Recurrent central serous chorioretinopathy, Choroidal neovascularization, Age-related macular degeneration, Intravitreous injection of bevacizumab, White dot syndrome
Reprint requests to
Shoko Satoh, M.D. Department Ophthalmology, Odate Municipal Hospital. 3-1 Yutaka-cho, Odate-shi 017-8550, Japan