PMC8077472_01
FA (a, b) and OCT (c, d) depicting (b, d) an active choroidal neovascular membrane with subretinal fluid secondary to sarcoidosis in the left eye at baseline. OCT 4 weeks after the 1st aflibercept injection (e), 2nd (f), 3rd (g), 4th (h), 5th injection (i), and 3 months following the 5th aflibercept injection showing neovascular membrane regression and subretinal fluid absence. FA, fluorescein angiography; OCT, optical coherence tomography.
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F1
LE early staining peripapillary and in the papillomacular bundle (Fig. 1a-d). Laboratory testing (full blood count, clotting, liver screen, viral screen, autoimmune screen, and QuantiferonTB gold) revealed no significant findings with the exception of angiotensin converting enzyme (ACE:148). The patient was managed with oral steroids (prednisolone 0.5 mg/kg), topical steroid eye drops (dexamethasone 0.1%), and cycloplegia in addition to 3 aflibercept injections that were administered in monthly intervals resulting in significant neovascular membrane regression and VA improvement (Fig. 1e-g). Two more aflibercept injections in monthly intervals followed, due to rapid NV recurrence (Fig. 1h-j).
OCT angiography depicting an active choroidal neovascular membrane with subretinal fluid secondary to sarcoidosis prior to a ranibizumab injection (a) and a preexisting peripapillary granuloma with an intact macula and no activity during follow-up (7 months after the last injection) (b). OCT, optical coherence tomography.
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F2
Overall, during a 50-month follow-up period up to April 2020, on every occasion, an anti-VEGF injection was followed by total NV regression, as depicted by OCT and OCT angiography (Fig. 2) and 6/6 VA.