Treatment of cystoid macular edema in a patient with birdshot chorioretinopathy with bevacizumab

Purpose: Birdshot chorioretinopathy is currently treated with either systemic immune modulation or intravitreal polytherapy. These regimens pose challenges to the clinician and patient such as adverse effects, chronic treatment and compliance, and failure of therapy. In a patient with birdshot chorioretinopathy and juxtaposed cystoid macular edema, the authors assessed the efficacy of bevacizumab for treatment after systemic therapy had failed. Methods: A 48-year-old woman was injected with intravitreal bevacizumab 10 times in her right eye with 4 weeks to 6 weeks intervening between injections. Improvement was monitored by best-corrected visual acuity and ocular coherence tomography. Results: Visual acuity improved from 20/200 to 20/30 in the right eye, and foveal thickness improved from 638 mm to 200 mm. Visible signs of macular edema and inflammation completely disappeared. Conclusion: Bevacizumab monotherapy may improve visual acuity with resolution of macular edema in patients with birdshot chorioretinopathy that is refractory to traditional systemic therapy.