scholarly journals Paediatric case of peripapillary choroidal neovascularisation associated with optic disc drusen treated with aflibercept

2019 ◽  
Vol 12 (1) ◽  
pp. bcr-2018-228134 ◽  
Author(s):  
Weh Loong Gan ◽  
Vernon W Long
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Rare Complication ◽  
Fundus Autofluorescence ◽  
Choroidal Neovascularisation ◽  
First Case ◽  
Optic Disc Drusen ◽  
Intravitreal Aflibercept ◽  
The Right ◽  
Subfoveal Fluid

Peripapillary choroidal neovascularisation (PPCNV) associated with optic disc drusen is a rare complication that can result in severe vision impairment in children. We report the first case of paediatric PPCNV secondary to optic disc drusen successfully treated with intravitreal aflibercept. A 6-year-old girl presented with a one week history of reduced vision in her right eye with best-corrected visual acuity of 20/500. Fundus examination revealed bilateral elevated discs with a peripapillary pigmentary lesion in the right eye. Optical coherence tomography of the right eye showed marked subfoveal fluid. Both B-scan ultrasonography and fundus autofluorescence demonstrated findings consistent with optic disc drusen. Diagnosis of PPCNV was further confirmed on fluorescein fundus angiography. The child received three intravitreal aflibercept injections with complete resolution of the subfoveal fluid. Her visual acuity improved to 20/25 with no recurrence at a 16-month follow-up. No adverse side effects were reported.

scholarly journals Optic Coherence Tomography Angiography Findings of Bilateral Choroidal Neovascularization Associated with Optic Disc Drusen Treated with Intravitreal Aflibercept Injection

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Melih Akıdan ◽  
Mehmet Bulut ◽  
Lütfiye Yaprak ◽  
Muhammet Kazım Erol ◽  
Elcin Suren
Keyword(s):  
Optic Disc ◽  
Choroidal Neovascularization ◽  
Fundus Photography ◽  
Vascular Density ◽  
Optic Coherence Tomography ◽  
Main Trunk ◽  
Optic Disc Drusen ◽  
Intravitreal Aflibercept ◽  
The Right ◽  
Sd Oct

Purpose. The purpose of this case report is to present the findings of optical coherence tomography angiography (OCTA) of a patient with bilateral choroidal neovascularization (CNV) associated with optic disc drusen (ODD), who was treated with intravitreal aflibercept injection. Case presentation. A 14-year-old girl presented with a complaint of visual loss and metamorphopsia in her both eyes. Best-corrected visual acuity (BCVA) was 20/32 and 20/25, respectively, in the right and left eyes. Intraocular pressure and anterior segment examination were normal. Dilated fundus examination revealed elevated optic discs with blurred margins in both eyes. In addition, slightly elevated yellow lesion extending from optic nerve head to the macula was observed bilaterally. The patient underwent imaging with colour fundus photography, fundus autofluorescence (FAF), fundus fluorescein angiography (FFA), spectral-domain optic coherence tomography (SD-OCT), OCTA, orbital ultrasonography (USG), and computed tomography (CT). In particular, OCTA demonstrated clearly the large circular CNV complex in the right eye and the CNV structure in the left eye containing slightly activated main trunk and minimal vessel loops in the papillomacular region. CNV secondary to bilateral ODD was suspected. Intravitreal aflibercept injections were performed in 3 doses to the right eye and a single dose to the left eye. After the injections, BCVA reached its complete level in both eyes. SD-OCT revealed irregularity of RPE in the temporal region of the optic disc and complete regression of the subretinal fluid. Interestingly, the entire CNV complex including the main trunk completely disappeared in OCTA. CNV complex was not observed in OCTA during 1-year follow-up, and peripapillary and macular vascular density measurements did not show any significant change. BCVA was preserved, and no additional injections were needed. Conclusion. It is possible that OCTA can be used for detailed evaluation of CNV associated with ODD, response to anti-VEGF treatment, and peripapillary and macular vascular density. There is a need for further studies to confirm the changes such as disappearance of CNV in OCTA after injection as we observed in our patient.

scholarly journals Intravitreal Aflibercept in Recalcitrant Radiation Maculopathy due to External Beam Radiotherapy for Nasopharyngeal Cancer: A First Case Report

2017 ◽  
Vol 8 (1) ◽  
pp. 87-90 ◽  
Author(s):  
Eleni Loukianou ◽  
Georgia Loukianou
Keyword(s):  
Visual Acuity ◽  
Retinal Thickness ◽  
External Beam Radiotherapy ◽  
Nasopharyngeal Cancer ◽  
External Beam ◽  
Safety And Efficacy ◽  
Corrected Visual Acuity ◽  
First Case ◽  
Intravitreal Aflibercept ◽  
The Right

Purpose: To present the safety and efficacy of intravitreal aflibercept (Eylea) in a patient with radiation maculopathy secondary to external beam radiotherapy for nasopharyngeal cancer unresponsive to other therapeutic options. Methods: A 73-year-old female presented with decreased visual acuity in both eyes 18 months after completing 47 external beam cycles of radiation for nasopharyngeal cancer. On presentation, her best corrected visual acuity was 6/60 in the right eye and counting fingers from 1 meter in the left eye. She received 5 bevacizumab injections in the right eye and 7 bevacizumab injections in the left eye over the last year without any improvement. A treatment with intravitreal injections of aflibercept was recommended in both eyes. Results: The patient received 3 intravitreal aflibercept injections (2 mg/0.05 mL) in each eye every 4 weeks. The visual acuity improved from 6/60 to 6/12 in the right eye and from counting fingers to 6/36 in the left eye. Biomicroscopy showed less exudates, hemorrhages, and microaneurysms. Optical coherence tomography revealed reduced central retinal thickness in both eyes after 1–3 intravitreal aflibercept injections. Conclusion: Intravitreal aflibercept should be regarded a safe and effective treatment in patients with recalcitrant macular edema due to radiation maculopathy.

Multimodal imaging in IRVAN syndrome presenting with Branch Retinal Artery Occlusion

2020 ◽  
pp. 112067212096549
Author(s):  
Sourour Zina ◽  
Imen Ksiaa ◽  
Chiraz Abdelhedi ◽  
Hager Ben Amor ◽  
Sonia Attia ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Disc ◽  
Multimodal Imaging ◽  
Fundus Autofluorescence ◽  
Retinal Artery Occlusion ◽  
Artery Occlusion ◽  
Branch Retinal Artery Occlusion ◽  
Hard Exudates ◽  
Retinal Artery ◽  
The Right

Purpose: To describe multimodal imaging findings in a patient with idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome presenting with branch retinal artery occlusion (BRAO). Case description: A 33-year-old woman presented with acute BRAO in the right eye. A diagnosis of underlying IRVAN syndrome was made based on the presence of arteriolar aneurysms on the optic disc and along major arterioles and faint retinal hard exudates in both eyes. Eight months later, best-corrected visual acuity was 20/25 in the right eye and 20/20 in the left eye. The hard exudates had increased, and there were extensive areas of peripheral retinal capillary nonperfusion without new vessels. Optical coherence tomography (OCT) showed a localized retinal thinning corresponding to the prior BRAO. Fundus autofluorescence showed nodulo-linear periarterial hypoautofluorescence. OCT angiography (OCTA) showed localized ischemic changes, mainly involving the deep capillary plexus, corresponding to the area of resolved BRAO. It also clearly delineated the optic disc aneurysms. The patient received bilateral scatter laser photocoagulation directed to areas of peripheral capillary nonperfusion. Over a 6-month follow-up period, visual acuity remained unchanged, and there was no evidence of disease progression. Conclusion: Multimodal imaging, including fundus autofluorescence, OCT, and OCTA can provide additional valuable information in the evaluation of IRVAN syndrome complicated with BRAO.

scholarly journals Clinical Phenotype of PDE6B-Associated Retinitis Pigmentosa

2021 ◽  
Vol 22 (5) ◽  
pp. 2374
Author(s):  
Laura Kuehlewein ◽  
Ditta Zobor ◽  
Katarina Stingl ◽  
Melanie Kempf ◽  
Fadi Nasser ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Genetic Testing ◽  
Retinitis Pigmentosa ◽  
Fundus Autofluorescence ◽  
Retinal Disease ◽  
New Drugs ◽  
Autofluorescence Imaging ◽  
Full Field ◽  
Tertiary Referral Center ◽  
The Right

In this retrospective, longitudinal, observational cohort study, we investigated the phenotypic and genotypic features of retinitis pigmentosa associated with variants in the PDE6B gene. Patients underwent clinical examination and genetic testing at a single tertiary referral center, including best-corrected visual acuity (BCVA), kinetic visual field (VF), full-field electroretinography, full-field stimulus threshold, spectral domain optical coherence tomography, and fundus autofluorescence imaging. The genetic testing comprised candidate gene sequencing, inherited retinal disease gene panel sequencing, whole-genome sequencing, and testing for familial variants by Sanger sequencing. Twenty-four patients with mutations in PDE6B from 21 families were included in the study (mean age at the first visit: 32.1 ± 13.5 years). The majority of variants were putative splicing defects (8/23) and missense (7/23) mutations. Seventy-nine percent (38/48) of eyes had no visual acuity impairment at the first visit. Visual acuity impairment was mild in 4% (2/48), moderate in 13% (6/48), and severe in 4% (2/48). BCVA was symmetrical in the right and left eyes. The kinetic VF measurements were highly symmetrical in the right and left eyes, as was the horizontal ellipsoid zone (EZ) width. Regarding the genetic findings, 43% of the PDE6B variants found in our patients were novel. Thus, this study contributed substantially to the PDE6B mutation spectrum. The visual acuity impairment was mild in 83% of eyes, providing a window of opportunity for investigational new drugs. The EZ width was reduced in all patients and was highly symmetric between the eyes, making it a promising outcome measure. We expect these findings to have implications on the design of future PDE6B-related retinitis pigmentosa (RP) clinical trials.

scholarly journals Recurrent Self-Induced Nontraumatic Orbital Emphysema Causing Orbital Compartment Syndrome with Optic Nerve Dysfunction

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
S. Cutting ◽  
C. Davies-Husband ◽  
C. Poitelea
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Compartment Syndrome ◽  
Valsalva Manoeuvre ◽  
First Case ◽  
Orbital Emphysema ◽  
History Of ◽  
Nerve Dysfunction ◽  
The Right ◽  
Needle Decompression

The majority of cases of orbital emphysema are due to trauma. Complications are rare, and therefore, the need for surgical intervention is uncommon. We present the first case of which we are aware in which nontraumatic orbital emphysema led to orbital compartment syndrome and subsequent optic nerve dysfunction. The patient underwent emergency needle decompression. A 51-year-old man presented to the Emergency Department with right-sided unilateral proptosis, reduced visual acuity, and binocular diplopia. This occurred after performing a Valsalva manoeuvre with no history of head trauma. He also mentioned that over the past year he had experienced multiple episodes of transient proptosis occurring after Valsalva manoeuvres. Visual acuity in the right eye was reduced to 6/21. A relative afferent pupillary defect was present and intraocular pressure (IOP) was 12 mmHg. The CT scan showed significant orbital emphysema in the medial aspect of the right orbit. Needle decompression was performed resulting in immediate resolution of his symptoms. This case demonstrates that, in cases of orbital emphysema, a lack of a history of trauma and a normal IOP cannot always be used to rule out serious pathology.

Delayed-onset unilateral Vogt-Koyanagi-Harada syndrome: a multimodal imaging appraisal

2021 ◽  
Vol 14 (2) ◽  
pp. e238623
Author(s):  
Saurabh Verma ◽  
Himani Thakur ◽  
Shorya Vardhan Azad ◽  
Vinod Kumar
Keyword(s):  
Multimodal Imaging ◽  
Intravitreal Bevacizumab ◽  
Choroidal Neovascularisation ◽  
Enhanced Depth Imaging ◽  
Depth Imaging ◽  
Delayed Onset ◽  
First Case ◽  
Imaging Optical Coherence Tomography ◽  
The Right ◽  
Active Inflammation

A 38-year-old woman who had previously been diagnosed and treated for unilateral Vogt-Koyanagi-Harada syndrome (VKH) and had undergone multiple intravitreal bevacizumab injections to manage inflammatory choroidal neovascularisation in her right eye, presented 2 years later with visual complains in left eye. Clinical examination, fluorescein angiography, indocyanine green angiography (ICGA) and enhanced depth imaging optical coherence tomography (EDI-OCT) assisted evaluation confirmed active inflammation of left eye along with absence of any inflammation in the right eye. Unilateral active inflammation can be seen in the setting of VKH. To our best knowledge, ours is the first case of VKH in which unilateral active inflammation has been proven based on ICGA and EDI OCT analysis.

scholarly journals Pseudophacocele following a Bicycle Handle Injury: A Case Report

2018 ◽  
Vol 10 (1) ◽  
pp. 94-97
Author(s):  
Sahil Thakur ◽  
Parul Ichhpujani ◽  
Suresh Kumar
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Blunt Trauma ◽  
Surgical Management ◽  
Clinical Course ◽  
Rare Complication ◽  
Vitreous Haemorrhage ◽  
Visual Outcomes ◽  
Subconjunctival Space ◽  
The Right

Background: Pseudophacocele is a rare complication of blunt trauma in pseudophakic eyes.Case: We present a case of 60-year-old male who presented with pseudophacocele after injury from a bicycle handle. On presentation, visual acuity in the right eye was perception of light (PL) in 2 quadrants (superior and temporal) and left eye was 20/20. A PCIOL was seen superonasally in the right subconjunctival space with total hyphaema. Ultrasound demonstrated vitreous haemorrhage with membranes in right eye. We describe the surgical management and further clinical course of the patient.Conclusion: It is imperative to surgically manage these challenging cases. Despite optimum care visual outcomes are guarded in patients with severe blunt trauma.

scholarly journals Photodynamic Therapy for Juxtapapillary Retinal Capillary Hemangioma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Panagiotis G. Mitropoulos ◽  
Irini P. Chatziralli ◽  
Vasileios G. Peponis ◽  
Vasileia A. Tsiotra ◽  
Efstratios A. Parikakis
Keyword(s):  
Visual Acuity ◽  
Photodynamic Therapy ◽  
Optic Disc ◽  
Anterior Segment ◽  
Capillary Hemangioma ◽  
Treatment Modalities ◽  
Inferior Margin ◽  
Retinal Capillary ◽  
Retinal Capillary Hemangioma ◽  
The Right

Various treatment modalities have been described for retinal capillary hemangioma. Our purpose is to present a case of juxtapapillary retinal capillary hemangioma treated with photodynamic therapy. A 69-year-old woman with no previous ocular history presented with blurred vision and photopsias in the right eye three months ago. At presentation, her best corrected visual acuity was 6/9 in the right eye and 6/6 in the left eye. The anterior segment was totally normal and IOP was normal in both eyes as well. Dilated fundoscopy revealed a yellowish, well-circumscribed, elevated area with blood vessels, on the inferior margin of the right optic disc, as optic disc edema. Fluorescein angiography and angiogram with indocyanine green confirmed the diagnosis of juxtapapillary retinal capillary hemangioma. The patient was treated with photodynamic therapy with verteporfin and three months later her visual acuity was 6/7.5 in the right eye, while the lesion was slightly smaller. These findings remained stable at the one-year follow-up. In conclusion, photodynamic therapy offers promising anatomical and functional results for juxtapapillary retinal capillary hemangioma, providing visual acuity improvement or even stabilization and restriction of enlargement of the lesion.

scholarly journals Retinal hemorrhages as one of complications of optic disc drusen during pregnancy

2014 ◽  
Vol 67 (5-6) ◽  
pp. 185-189
Author(s):  
Marija Trenkic-Bozinovic ◽  
Predrag Jovanovic ◽  
Gordana Zlatanovic ◽  
Dragan Veselinovic ◽  
Aleksandra Aracki-Trenkic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Optic Nerve ◽  
Visual Field ◽  
Optic Disc ◽  
Optic Nerve Head ◽  
Ganglion Cells ◽  
Therapeutic Interventions ◽  
Visual Field Defects ◽  
Retinal Hemorrhages ◽  
Optic Disc Drusen

Introduction. Drusen of the optic nerve head are relatively benign and asymptomatic. They represent retinal hyaline corpuscles resulting from impaired axoplasmic transport of the retinal ganglion cells of optic nerve in front of the lamina cribrosa. They are usually detected accidentally, during a routine ophthalmologic examination. Most patients with optic disc drusen are not aware of the deterioration of their eyesight because of the slow progression of visual field defects. Damage in visual acuity due to optic disc drusen is rare. Case Report. A 27-year-old female patient in the sixth month of pregnancy visited an ophthalmologist because of a visual impairment described as the appearance of mist and shadows over her right eye. When first examined, her visual acuity in both eyes was 20/20. The retinal hemorrhages framing the bottom half of the optic nerve were seen. Complete laboratory and clinical testing as well as specific ophthalmic examinations (photofundus, computerized visual field, optical coherence tomography, and ultrasound) were performed to exclude systemic causes and they presented no risk for the pregnancy. Echosonographic examination confirmed the presence of bilateral optic nerve head drusen. Conclusion. Hemodynamic changes during pregnancy are possible factors for the development of optical disc and retinal hemorrhages. Since treatment of optic disc drusen is limited, recognition of optic nerve drusen as a cause of hemorrhage during pregnancy prevents unnecessary diagnostic and therapeutic interventions.

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