Case Of Choroidal Neovascular Membrane Research Articles

CHOROIDAL NEOVASCULARIZATION AS A LATE COMPLICATION OF SYPHILITIC CHORIORETINITIS MANAGED WITH INTRAVITREAL AFLIBERCEPT.

To report a rare case of choroidal neovascular membrane (CNV) developed three years after acquired syphilitic chorioretinitis successfully treated with intravitreal aflibercept. Case report. A 44-year-old woman with bilateral decreased vision and a history of syphilitic chorioretinitis 3 years prior to presentation. Her best-corrected visual acuity was <20/400 in the right eye and 20/70 in the left eye. There was no evidence of anterior chamber or vitreous inflammation. Fundoscopy revealed a fibrovascular macular lesion associated with hemorrhages in both eyes. Optical coherence tomography (OCT) and OCT angiography confirmed the diagnosis of bilateral CNV. After ruling out other systemic diseases, the diagnosis of CNV as a late complication of syphilitic chorioretinitis was established. Although treatment was not recommended in the right eye, the left eye was treated with 3 monthly intravitreal injections of aflibercept as a solo therapy. Three weeks after the last injection, the visual acuity improved to 20/25 and remained stable at the 6-month follow-up with no evidence of CNV reactivation. Choroidal neovascular membranes can occur as a late complication of syphilitic chorioretinitis. Solo treatment with intravitreal injections of the anti-vascular endothelial growth factor aflibercept effectively controlled CNV activity and improved visual acuity.

A case of choroidal neovascular membrane in Best vitelliform macular dystrophy treated with intravitreal brolucizumab

A 21-year-old healthy male presented with loss of vision associated with metamorphopsia in the right eye of 6 weeks duration. The patient was a known case of best vitelliform macular dystrophy in both eyes. Clinical and imaging studies lead to a diagnosis of the choroidal neovascular membrane (CNVM). The diseased eye was treated with a single dose of intravitreal brolucizumab. Significant gains in visual acuity and reduction in the subretinal fluid were noted over 2 months of follow-up. Intravitreal brolucizumab can be an effective option in treating CNVMs associated with macular dystrophy.

Choroidal neovascular membrane: Report of pediatric idiopathic case

The choroid neovascular membrane is a rare cause of central vision loss among children. Its etiopathogenesis is still unclear and the management is not standardized. The neovascularization may be due to inflammatory, post-traumatic, or dystrophic causes. We described herein a case of choroidal neovascular membrane in a 14-year-old boy with no evident origin after investigations. Keywords: choroidal neovascular membrane, idiopathic, child.

Torpedo maculopathy: disease spectrum and associated choroidal neovascularisation in a paediatric population.

Torpedo maculopathy is a rare lesion of the retinal pigment epithelium. This study set out to look at these lesions in the paediatric population and determine the spectrum and features of the disease. The paediatric ophthalmology database was used to identify eight children with torpedo maculopathy between 2012 and 2017. Fundal images and optical coherence tomography (OCT) was used to analyse the cases. Eight patients with torpedo maculopathy were identified, making the prevalence approximately 2 per 100,000 population under 16 years old. The OCT images were classified using the previously described subtypes: Type 1 in patients 5 and 6 and Type 2 in patients 1, 2, 3, 4 and 8. The average age of presentation of Type 1 and Type 2 lesions was 8 and 7 years old respectively. We also report patient 8, who is the youngest reported case of choroidal neovascular membrane associated with torpedo maculopathy. Good anatomical response to a single injection of anti-Vegf was shown. This study is the first case series of torpedo maculopathy in the paediatric population. Contrary to previous reports of two distinct types of lesion on OCT representing different stages of the same disease, our case series indicates that Type 1 and Type 2 lesions are in fact different phenotypic entities both of which can occur at a young age. We also present the associated risk of choroidal neovascular membrane formation which is an important consideration for long term follow-up.

A rare case of choroidal neovascularization following macular hole surgery

Choroidal neovascularization occurs in a wide spectrum of conditions, including degenerative, inflammatory, traumatic and hereditary conditions, all of which are characterized by breaks in Bruch's membrane. A few cases of choroidal neovascular membrane (CNVM) have been reported in the literature following macular hole surgery. We present a retrospective case study of a single patient who developed CNVM after successful macular hole surgery. The 70-year-old diabetic female underwent macular hole surgery in her right eye. Posterior hyaloid was separated with suction and vitrectomy was performed. Internal limiting membrane (ILM) was stained with trypan blue under air and ILM peeling was performed. Perfluoropropane (C3F8) gas was used as the tamponade. Six weeks post-operation, closure of macular hole was seen. Six months later, she presented with defective vision. Subfoveal classic CNVM was seen in the same eye. About 1%-3% of patients who undergo macular hole surgery develop CNVM. Age-related changes and surgical trauma are considered to be the predisposing factors in reported cases. Injury to the retinal pigment epithelium (RPE) during surgery may be an important factor in our case, since there were no pre-existing age-related changes. CNVM though rare can occur after macular hole surgery, especially in the setting of age-related changes. Injuries to the RPE should be avoided during surgery. We report a case of CNVM after macular hole in which trypan blue was used as a staining agent.

Laser photocoagulation for choroidal neovascular membrane associated with optic disc drusen

To report two cases of choroidal neovascular membrane associated with optic disc drusen which were successfully treated using argon laser photocoagulation. Choroidal neovascular complications of optic disc drusen were diagnosed in two of our patients, a 36-year-old woman and a 14-year-old girl. In both cases visual acuity was 20/100 in the affected eye. Fundus examination and angiography revealed a choroidal neovascular membrane. Computer tomography identified bilateral calcified drusen of the optic discs. Photocoagulation of neovascular tissues was immediately performed. Visual acuity improved progressively, reaching 20/20 10 months after treatment in one case and 20/30 in the other. No recurrence was observed during follow-up. Early diagnosis and immediate laser photocoagulation of vision-threatening choroidal neovascular membranes associated with optic disc drusen helps stop progression towards the macula and improves longterm visual acuity.

Photodynamic Therapy with Verteporfin for Subfoveal Choroidal Neovascular Membranes in Highly Myopic Eyes After Laser In situ Keratomileusis

The authors describe the management of subfoveal choroidal neovascular membranes in highly myopic eyes after laser in situ keratomileusis with photodynamic therapy. Five cases of choroidal neovascular membrane after laser in situ keratomileusis for the correction of myopia (mean, 13.3 diopters; range, -8.00 to -16.25 diopters) treated with single or multiple sessions of photodynamic therapy with verteporfin are presented. Two cases had improved visual acuity (2 to 5 lines) after photodynamic therapy, two cases remained the same, and one case lost 4 lines of visual acuity. Photodynamic therapy with verteporfin seems to increase the chance of stabilizing or improving vision in patients with subfoveal choroidal neovascular membrane after laser in situ keratomileusis in highly myopic eyes.

Foveal Translocation: A Comparison of two Techniques

Subfoveal choroidal neovascular membrane is a leading cause of legal blindness. Photocoagulation has been effective, but photocoagulation of the fovea causes a decrease in vision immediately after treatment. Surgical removal of the choroidal neovascular membrane is effective for choroidal neovascular membrane in some cases, but it restores useful vision for reading (20/40 or better) in a small number of cases of choroidal neovascular membrane not due to presumed ocular histoplasmosis syndrome. A new treatment for subfoveal choroidal neovascular membrane, foveal translocation, is an innovative procedure in which the fovea is translocated onto healthier retinal pigment epithelium. Three techniques have been developed to relocate the retina, 2 of which (retinotomy and scleral shortening) we performed in 5 cases each. Preliminary results in these 10 cases indicate that foveal translocation provides improvement of visual acuity in 40% of eyes and final visual acuities useful for reading (better than 20/40) in 20% of eyes undergoing translocation with either technique. Further study is essential to refine the amount of translocation needed and to decrease complications of the 2 techniques, including retinal detachment, proliferative vitreoretinopathy, macular pucker, corneal astigmatism, and constricted visual field.