Idiopathic choroidal neovascularisation in pregnancy: treatment options and a successful outcome

BMJ Case Rep. 2016 Jul 19:2016:bcr2016215787. doi: 10.1136/bcr-2016-215787.

Abstract

Choroidal neovascularisation (CNV) is a major cause of visual loss and treatment options aim to halt progression and stabilise vision. We describe a 29-year-old woman who presented with blurred vision and distortion in her left eye while 26 weeks pregnant. She was diagnosed with idiopathic CNV and multiple treatment options were discussed. The patient did not want to undertake any risks from having an anti vascular endothelial growth factor agent during pregnancy. Therefore on discussion with the obstetric team, she elected to have early delivery at 32 weeks followed by a course of intravitreal bevacizumab. Subsequently there was resolution of symptoms and intraretinal and subretinal fluid. CNV is uncommonly seen in pregnancy and there remains no consensus on treatment. We describe the third reported case of idiopathic CNV in pregnancy. Careful patient counselling and close liaison between the ophthalmology and obstetric teams are necessary in this condition to obtain a safe outcome while maximising vision.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / therapeutic use
  • Bevacizumab / therapeutic use
  • Choroidal Neovascularization / diagnostic imaging*
  • Choroidal Neovascularization / drug therapy*
  • Female
  • Humans
  • Intravitreal Injections
  • Pregnancy
  • Pregnancy Complications / diagnostic imaging*
  • Pregnancy Complications / drug therapy*
  • Premature Birth
  • Tomography, Optical Coherence
  • Treatment Outcome

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab