Regression of Bilateral Peripapillary Choroidal Neovascularization Associated with Idiopathic Intracranial Hypertension after Systemic Acetazolamide Treatment

Omer Trivizki; Liang Wang; Prashanth Iyer; Yingying Shi; Philip J Rosenfeld; David Rabinovitch; Justin Townsend

doi:10.1159/000522143

Regression of Bilateral Peripapillary Choroidal Neovascularization Associated with Idiopathic Intracranial Hypertension after Systemic Acetazolamide Treatment

Case Rep Ophthalmol. 2022 Apr 19;13(1):270-275. doi: 10.1159/000522143. eCollection 2022 Jan-Apr.

Authors

Omer Trivizki^{1

2}, Liang Wang¹, Prashanth Iyer¹, Yingying Shi¹, Philip J Rosenfeld¹, David Rabinovitch², Justin Townsend¹

Affiliations

¹ Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA.
² Department of Ophthalmology, Tel Aviv Medical Center, University of Tel Aviv, Tel Aviv, Israel.

Abstract

A rare occurrence of bilateral peripapillary choroidal neovascularization (CNV) in an 18-year-old idiopathic intracranial hypertension (IIH) patient regressed with systemic acetazolamide treatment alone. Multimodal imaging was done, including OCT angiography (OCTA), which showed CNV. No injections were given even though she had macular fluid in her left eye. Nonetheless, the subretinal fluid resolved, and visual acuity improved. This report shows that CNV secondary to IIH can be managed with systemic therapy alone. Moreover, we showed for the first time the ability to diagnose IIH-associated CNV using OCTA.

Keywords: Acetazolamide; Idiopathic intracranial hypertension; Multimodal imaging; Optical coherence tomography angiography angiography; Peripapillary choroidal neovascularization; Vascular endothelial growth factor.

Publication types

Case Reports