Risankizumab-Rzaa in the Management of Birdshot Chorioretinopathy: A Case Report.

PURPOSE: Risankizumab-rzaa injections were recently approved for the management of psoriasis, psoriatic arthritis and crohn's disease. However, its use in managing birdshot chorioretinopathy (BSCR) has not been reported. We report the first case of risankizumab-rzaa found to help control inflammation in birdshot chorioretinopathy.

METHODS

A retrospective review of the patient's record was done to obtain data for a case report.

CASE PRESENTATION: A 71-year-old male with BSCR, complicated by cystoid macular edema (CME), presented with decreased vision in the right eye (OD) for 4 days. He had been on risankizumab-rzaa 150 mg subcutaneous injection monotherapy every 12 weeks for his psoriatic arthritis. He remained in ocular flare free remission for 3 years while on this medication alone. At one point, the patient's risankizumab-rzaa injection got delayed and he subsequently developed worsening vision OD (visual acuity worsened from 20/80 to 20/100 OD) and was found to have CME OD diagnosed by optical coherence tomography scan (OCT) with a central subfield retinal thickness (SFRT) of 213 μm OD.

RESULTS

After receiving the delayed risankizumab-rzaa injection, the patient's visual acuity improved (from 20/100 to 20/70 OD). OCT demonstrated resolution of his CME in the right eye with SFRT of 186 μm. We performed an extensive literature review on the use of risankizumab-rzaa with BSCR, which yielded no results for any such studies.

CONCLUSION

Risankizumab-rzaa may be an effective treatment for BSCR. Further studies are needed to establish long-term efficacy for this medication in treating such forms of uveitis.