Persistent macular edema with secondary neovascular membrane following a panuveitis in woman with Behçet’s disease resolved by a switching to aflibercept injections

Purpose To report the effective treatment of a neovascular membrane following recurrent panuveitis associated to Behçet’s Disease, in a woman no responders to cyclosporine and biological response modifiers, refractory to ranibizumab, who was switched to aflibercept injections. Methods An interventional case report with optical coherence tomography (OCT) scans. Results A 56-year-old Caucasian woman was suffering from recurrent panuveitis on both eyes for Behçet’s Disease with a neovascular membrane on left eye. She had undergone one entire cycle of therapy with cyclosporine (5mg/Kg/die) and two infusion of infliximab which resolved panuveitis, without functional or anatomical improvement of the eye clinic on the left eye. Six months after the second infusion of infliximab, she received two consecutive intravitreal injections of ranibizumab with the persistent of the neovascular activity and without any improvement of visual acuity (VA). Four weeks following the second injection, the treatment was switched to two aflibercept injections. Two weeks later, her best-corrected visual acuity improved from 0.4 to 0.7. Macular edema resolved with a reduction of central retinal thickness from 398 μm before Aflibercept injections to 274 μm after Aflibercept injections, as measured by OCT scan. Conclusion Aflibercept could be a new therapeutic,effective,safe,local treatment option in patients with complicated noninfectious uveitis as Behçet’s Disease, no responders to immunosuppressive agents or immunobiological response modifiers and previous anti-VEGF treatments.