Aflibercept as a Treatment for Secondary Central Serous Chorioretinopathy in a Patient With Myasthenia Gravis

• Published in: Curēus (Palo Alto, CA) CA), 2022-11, Vol.14 (11), p.e31287
• Main Authors: Ramirez Marquez, Estefania, Requejo Figueroa, Guillermo A, Pappaterra-Rodriguez, Mariella, Ayala Rodríguez, Sofía C, Puebla, Guillermo, Nieves, Ileana, Oliver, Armando L
• Format: Article
• Language: English
• Subjects: Case reports; Drug therapy; Etiology; Lasers; Myasthenia gravis; Ophthalmology; Permeability; Retinal detachment; Shellfish; Steroids; Systemic diseases; Tomography; Vascular endothelial growth factor; Visual acuity
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.31287

We report on a case of central serous chorioretinopathy (CSCR) secondary to chronic steroid use that showed sustained improvement when treated with an aflibercept intravitreal injection. A 44-year-old woman presented with decreased visual acuity of the left eye (OS). The patient had a recent history of myasthenia gravis and was being treated with systemic corticosteroids and immunosuppressants. At presentation, her visual acuity was 20/80 OS; an examination (using fluorescein angiography) of the left fundus revealed a serous retinal detachment of the posterior pole that extended to the mid-periphery and multiple areas of leakage, which findings were consistent with CSCR. The patient also had a history of unresolved strabismic amblyopia in her right eye. The patient's CSCR was managed with one injection of intravitreal aflibercept (2 mg/0.05 mL). One month following treatment, her visual acuity improved to 20/20 OS, and the serous retinal detachment had resolved. Ten months following treatment, an examination revealed a sustained improvement, with a visual acuity of 20/20 OS. Concomitantly, the patient's amblyopic eye revealed an improved visual acuity of 20/20. Our case suggests that some cases of secondary CSCR may respond to treatment with intravitreal aflibercept. This case also suggests that the CSCR imposed a unique form of occlusion therapy that helped improve the amblyopia of the contralateral eye in this adult patient.