Supplementary Material for: A Temporal Association Between Regression of Pachydrusen and Use of Proprotein Convertase Subtilisin Kexin 9 (PCSK9) Inhibitor: A Case Report

Introduction: We aim to report the clinical course of a patient with pachychoroidopathy who experienced regression of subfoveal drusen during cholesterol treatment using PCSK9 inhibitors.
Case presentation: A 62-year-old woman who had been visually asymptomatic complained of recent visual loss in the left eye (OS). She had been diagnosed with foveal pachydrusen OS that had remained stable for ten years. Three months after starting cholesterol treatment with a PCSK9 inhibitor, the latest class of lipid-lowering medication, her vision improved in parallel with the gradual regression of material deposited beneath the retinal pigment epithelium (RPE). Recurrence of drusen was observed after discontinuing the drug.
Conclusions: Use of PCSK9 inhibitors may improve the retina’s lipid homeostasis by increasing number of RPE-LDL receptors, and partly contribute to the improvement of ocular phenotypes associated with dysfunctional RPE in pachychoroidopathy.