Luo L, Chen WB, Zhao MW, Miao H. Systemic combined with intravitreal methotrexate for relentless placoid chorioretinitis: A case report. World J Clin Cases 2022; 10(35): 13115-13121 [PMID: 36569015 DOI: 10.12998/wjcc.v10.i35.13115]
Corresponding Author of This Article
Heng Miao, MD, Doctor, Department of Ophthalmology & Clinical Center of Optometry, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. sawyer_young@sina.com
Research Domain of This Article
Biochemical Research Methods
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 16, 2022; 10(35): 13115-13121 Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.13115
Systemic combined with intravitreal methotrexate for relentless placoid chorioretinitis: A case report
Lan Luo, Wei-Bin Chen, Ming-Wei Zhao, Heng Miao
Lan Luo, Wei-Bin Chen, Ming-Wei Zhao, Heng Miao, Department of Ophthalmology & Clinical Center of Optometry, Peking University People’s Hospital, Beijing 100044, China
Lan Luo, Wei-Bin Chen, Ming-Wei Zhao, Heng Miao, Eye Diseases and Optometry Institute, Peking University People's Hospital, Beijing 100044, China
Lan Luo, Wei-Bin Chen, Ming-Wei Zhao, Heng Miao, College of Optometry, Peking University Health Science Center, Beijing 100191, China
Lan Luo, Wei-Bin Chen, Ming-Wei Zhao, Heng Miao, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Peking University People's Hospital, Beijing 100044, China
Author contributions: Luo L, Chen WB, Zhao MW, and Miao H contributed to material preparation, data collection and analysis were performed; Luo L and Chen WB contributed to the main manuscript was written; Miao H provided a critical review of the manuscript; all authors have read the article and approved the final version.
Supported bythe National Natural Science Foundation of China, No. 81800847; and the Tenth “Academic Star” project of Peking University People's Hospital, No. RS2018-05.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Heng Miao, MD, Doctor, Department of Ophthalmology & Clinical Center of Optometry, Peking University People’s Hospital, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, China. sawyer_young@sina.com
Received: October 7, 2022 Peer-review started: October 7, 2022 First decision: October 27, 2022 Revised: November 10, 2022 Accepted: November 24, 2022 Article in press: November 24, 2022 Published online: December 16, 2022 Processing time: 67 Days and 15.3 Hours
Abstract
BACKGROUND
We describe a case of relentless placoid chorioretinitis (RPC) that progressed despite administration of peribulbar and systemic corticosteroids, and was resolved by systemic combined with intravitreal methotrexate.
CASE SUMMARY
A 16-year-old male reported painless blurred vision and a temporal scotoma in his right eye for one week. Due to widespread distribution and continuous enlargement, multimodal imaging of the lesions led to the diagnosis of RPC. Lesions in the right eye extended despite peribulbar injection of triamcinolone acetonide, but the progression was immediately terminated by a single dose of intravitreal methotrexate. A new fresh lesion occurred in the contralateral eye despite systemic prednisolone but was resolved by oral methotrexate.
CONCLUSION
Systemic immunosuppressants should be given upon RPC diagnosis. Intravitreal methotrexate immediately halted progression and may be considered for sight-threatening cases as part of the initial therapy.
Core Tip: Relentless placoid chorioretinitis is a bilateral disease in nature and refractory to corticosteroid monotherapy, which warrants the importance of systemic immunosuppressants given upon diagnosis. Intravitreal methotrexate should also be considered as part of the initial therapy for macula-threatening cases in order to halt progression immediately and preserve visual function.
