case_images: PMC3975203_01
case_images: Ocular findings at initial presentation included bilateral posterior synechiae (a, right eye; b, left eye), macular edema (demonstrated by OCT, c, right eye; d, left eye), and peripheral retinal punched-out lesions (e, right eye; f, left eye).
case_images: cop-0005-0054-g01.jpg
case_images: PMC3975203_01_cop-0005-0054-g01.jpg
case_images: F1
case_images: Anterior segment examination revealed no corneal keratic precipitates, mild (+1) flare in the anterior chambers and posterior synechiae bilaterally (fig. 1a, b). Macular edema (fig. 1c, d) and peripheral retinal punched-out lesions were visible (fig. 1e).
case_images: Progression of the macular edema can be seen on OCT scans of the right eye (findings were similar in the left eye). At presentation (a), a significant macular edema was demonstrated, with an epiretinal membrane and mild vitreal opacification. Findings were stable at 3 months (b), but a worsening of the macular edema was noted at 6 months (c), and treated with an intravitreal injection of triamcinolone acetonide. Despite treatment and cessation of certolizumab, the macular edema persisted at 1 year (d).
case_images: cop-0005-0054-g02.jpg
case_images: PMC3975203_01_cop-0005-0054-g02.jpg
case_images: F2
case_images: Nevertheless, the macular edema persisted and the patient underwent periocular injections of 40 mg triamcinolone acetonide (Triesence; Alcon Inc.) in both eyes, with a partial resolution of the macular edema (fig. 2). The macular edema has improved, but still remains significant and is likely the cause of her impaired VA (fig. 2).