Intravitreal ranibizumab for treatment of choroidal neovascularization secondary to angioid streaks in pseudoxanthoma elasticum: Five-year follow-up

Purpose: To report on the five-year follow-up of ranibizumab therapy for choroidal neovascularization (CNV) secondary to angioid streaks (AS) in pseudoxanthoma elasticum (PXE). Methods: A 51-year-old patient with PXE presenting with macular CNV secondary to AS was treated with a series of intravitreal ranibizumab (0.5 mg) injections and followed for five years with fundoscopy, optical coherence tomography (OCT), and fluorescein angiography (FA). Results: Fluorescein leakage resolved and OCT evidence of subretinal and intraretinal fluid disappeared one year after presentation following an initial 12 injections. There was mild recurrent neovascular activity on two occasions resulting in two injections in the four years subsequent to resolution. Though peripapillary scar formation occurred, the fovea was preserved with 20/20 visual acuity in the affected eye at five years. Conclusions: This case provides further evidence for the long-term effectiveness of ranibizumab in the treatment of CNV secondary to AS in PXE. Though multiple initial injections were required to control the disease, once stabilization of the CNV was achieved, recurrent neovascular activity was minimal.