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Successful treatment of stellate multiform amelanotic choroidopathy with photodynamic therapy: A case report
Luuk van Gorcom1, Mehmet Ikinci1, Sankha Amarakoon1
1University Eye Clinic Maastricht, MUMC+, P. Debyelaan 25, 6229 HX, Maastricht, the Netherlands.
Purpose:
To report a case of stellate multiform amelanotic choroidopathy (SMACH) with focal hyperfluorescence on indocyanine green angiography (ICGA), successfully treated with photodynamic therapy (PDT).
Observations:
An 18-year-old male presented with subretinal fluid (SRF) overlying an irregular lesion in the inner choroid. A diagnosis of probable idiopathic macular neovascularization was made; treatment with intravitreal injections (IVIs) of anti-vascular endothelial growth factor (VEGF) agents showed no effect. The diagnosis was later revised to SMACH due to distinctive features on optical coherence tomography (OCT) and ICGA. Typically, no focal leakage is observed on ICGA in SMACH, and no successful treatment has been previously described. However, our case presented with focal leakage on ICGA, and treatment with full-dose PDT led to complete resolution of SRF.
Conclusions And Importance:
Diagnosing and treating SMACH can be challenging. No effective treatment has been reported to date. We describe a case with focal leakage on ICGA successfully treated with full-dose PDT. We suggest full-dose PDT as the first-line treatment of SMACH with associated focal leakage on ICGA.
