TREATMENT OF NOCARDIA CHORIORETINITIS-RELATED CHOROIDAL NEOVASCULARIZATION WITH AFLIBERCEPT: A CASE OF UNVEILED IMMUNOCOMPROMISE WITH ANTI-GM-CSF ANTIBODIES.
Edward Korot, Katherine E Jaje, Neena Singhal, Maria C Miglio
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Abstract
Purpose: The purpose of this study was to describe a case of Nocardia chorioretinitis-related choroidal neovascularization in a patient with anti-GM-CSF antibodies with resolution of choroidal neovascularization and visual recovery after a series of intravitreal anti-vascular endothelial growth factor.
Methods: This study is a case report.
Results: In this case, a 50-year-old woman, thought to be immunocompetent, presented with metamorphopsia and decreased visual acuity in the left eye in the setting of disseminated nocardiosis . She had evidence of a subfoveal Nocardia lesion with subretinal fluid and choroidal neovascularization. After a series of off-label injections with aflibercept, the patient had improvement in lesion size, exudation, and visual acuity. Extensive workup yielded underlying immunocompromise because of the presence of anti-GM-CSF antibodies, likely predisposing her to disseminated Nocardiosis.
Conclusion: The use of aflibercept in Nocardia chorioretinitis led to resolution of neovascular activity with visual recovery in a patient with disseminated Nocardiosis.