Systemic combined with intravitreal methotrexate for relentless placoid chorioretinitis: A case report

Figure 1 Multimodal imaging at initial presentation. A: Well-circumscribed fresh creamy-white serpiginous-like lesion around the optic disc and multiple pigmented scars were noted in the nasal and inferior mid-peripheral retina; B: Lesions in the right eye around the optic disc were hyperfluorescent on autofluorescence; C: in the late phase of fundus fluorescein angiography; D: Optical coherence tomography revealed normal fovea but disorganization of the outer retina in the nasal macular area in the right eye; E: The fundus of the left eye was unremarkable.

Figure 2 Multimodal imaging of the lesions two weeks after peribulbar injection of triamcinolone. A: Lesion extension was noted in the right eye, which showed; B: hyperfluorescent on autofluorescence; C: hypofluorescent on indocyanine green angiography; D: Optical coherence tomography of the right eye showed fovea involvement; E: The fundus of the left eye was still unremarkable.

Figure 3 Fundus photography, autofluorescence and optical coherence tomography during the patient’s follow-up. A and B: Two weeks after systemic methotrexate and prednisolone combined with intravitreal methotrexate, the lesions in the right eye were almost transparent and optical coherence tomography showed no further progression; C: A new creamy-white lesion appeared at six o’clock at the equator of the left eye; D-F: Another two weeks later, no progression was noted in the right eye; G and H: The lesion in the left eye also started to turn transparent without any modification of systemic therapy, but was still hyperfluorescent on autofluorescence; I-M: At the last visit, no new lesions or enlargement of the scars was noted in both eyes.