Treatment of Nocardia Chorioretinitis Related Choroidal Neovascularization with Aflibercept: A Case of Unveiled Immunocompromise with anti-GM-CSF Antibodies.

Purpose: The purpose of this study was to describe a case of Nocardia chorioretinitis-related choroidal neovascularization (CNV) in a patient with anti-GM-CSF antibodies with resolution of choroidal neovascularization and visual recovery following a series of intravitreal anti-vascular endothelial growth factor.

Methods: This study is a case report.

Results: In our case, a 50-year-old female, thought to be immunocompetent, presented with metamorphopsia and decreased visual acuity in the left eye in the setting of disseminated Nocardiosis. She had evidence of a subfoveal Nocardia lesion with subretinal fluid and CNV. Following a series of off-label injections with aflibercept, the patient had improvement in lesion size, exudation, and visual acuity. Extensive workup yielded underlying immunocompromise due to presence of anti-GM-CSF antibodies, likely predisposing her to disseminated Nocardiosis.

Conclusion: The use of aflibercept in Nocardia chorioretinitis led to resolution of neovascular activity with visual recovery in a patient with disseminated Nocardiosis.