scholarly journals Toxoplasma Retinochoroiditis with Chorioretinal Neovascularization in a Young Patient

2021 ◽  
pp. 259-263
Author(s):  
Nikhila S. Khandwala ◽  
Robert A. Hyde ◽  
Cagri G. Besirli
Keyword(s):  
Choroidal Neovascularization ◽  
Subretinal Fluid ◽  
Dual Therapy ◽  
Vascular Endothelial ◽  
Pediatric Case ◽  
Acute Case ◽  
Clinical Appearance ◽  
Retinal Examination ◽  
Blurry Vision ◽  
Endothelial Growth Factor

We present a pediatric case to highlight the clinical appearance and management of choroidal neovascularization in the setting of active toxoplasma retinochoroiditis (TRC). A 17-year-old female presented with 2 days of blurry vision in her left eye. Retinal examination demonstrated a pigmented chorioretinal lesion with associated subretinal fluid, vessel sheathing, and adjacent intraretinal hemorrhage. She was diagnosed with active choroidal neovascularization and successful treatment with bevacizumab revealed an underlying active toxoplasmosis lesion. Choroidal neovascularization may rarely present during an acute case of TRC. Dual therapy with anti-vascular endothelial growth factor antibody and anti-parasitic agents leads to improved visual outcomes.

scholarly journals Peripapillary Choroidal Neovascularization as an Unusual Complication of POEMS Syndrome

2017 ◽  
Vol 1 (1) ◽  
pp. oapoc.0000018
Author(s):  
Heleen Nicolai ◽  
Catherine Cassiman ◽  
Michel Delforge ◽  
Anita Leys
Keyword(s):  
Peripheral Neuropathy ◽  
Choroidal Neovascularization ◽  
Immunoglobulin A ◽  
Subretinal Fluid ◽  
Poems Syndrome ◽  
Unusual Complication ◽  
Vascular Endothelial ◽  
Optic Disc Edema ◽  
Skin Changes ◽  
Endothelial Growth Factor

Purpose To report the association of polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome with bilateral papilledema and bilateral choroidal neovascularization (CNV) in a 61-year-old man and to compare our findings with data from a review of the literature. Case report Diagnosis of POEMS syndrome was based on paraproteinemia immunoglobulin A lambda associated with progressive sensorimotor peripheral neuropathy and increased serum vascular endothelial growth factor (VEGF) levels. Shortly later, loss of vision of the left eye (LE) was noted and bilateral papilledema was observed with peripapillary hemorrhages and papillomacular subretinal fluid. Lenalidomide 25 mg daily and weekly dexamethasone 20 mg were administered and the patient was followed up closely. The systemic complaints initially were controlled and peripheral neuropathy improved. Regression of the papilledema and hemorrhages was observed as well as regression of the papillomacular edema in the LE. However, after a few months, the systemic VEGF levels increased, and an active CNV was diagnosed in the LE. Melphalan and prednisone were administered systemically, and the CNV was treated with bevacizumab intravitreal injections and these treatments proved to be effective. Conclusions Optic disc edema is reported frequently in POEMS syndrome but complication with CNV is rare, this being the second reported case.

scholarly journals Management of Uveitis-Related Choroidal Neovascularization: From the Pathogenesis to the Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Enzo D’Ambrosio ◽  
Paolo Tortorella ◽  
Ludovico Iannetti
Keyword(s):  
Choroidal Neovascularization ◽  
Intravitreal Bevacizumab ◽  
Posterior Uveitis ◽  
Age Related Macular Degeneration ◽  
Vascular Endothelial ◽  
Intravitreal Ranibizumab ◽  
Serpiginous Choroiditis ◽  
Age Related ◽  
Stromal Cell Derived Factor ◽  
Endothelial Growth Factor

Inflammatory choroidal neovascularization is a severe but uncommon complication of uveitis, more frequent in posterior uveitis such as punctate inner choroidopathy, multifocal choroiditis, serpiginous choroiditis, and Vogt-Koyanagi-Harada syndrome. Its pathogenesis is supposed to be similar to the wet age related macular degeneration: hypoxia, release of vascular endothelial growth factor, stromal cell derived factor 1-alpha, and other mediators seem to be involved in the uveitis-related choroidal neovascularization. A review on the factors implicated so far in the pathogenesis of inflammatory choroidal neovascularization was performed. Also we reported the success rate of single studies concerning the therapies of choroidal neovascularization secondary to uveitis during the last decade: photodynamic therapy, intravitreal bevacizumab, and intravitreal ranibizumab, besides steroidal and immunosuppressive therapy. Hereby a standardization of the therapeutic approach is proposed.

Predictors of treatment response to intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for choroidal neovascularisation secondary to chronic central serous chorioretinopathy

2019 ◽  
Vol 104 (7) ◽  
pp. 910-916 ◽  
Author(s):  
Khaled Romdhane ◽  
Marta Zola ◽  
Alexandre Matet ◽  
Alejandra Daruich ◽  
Martine Elalouf ◽  
...  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Treatment Response ◽  
Predictive Factors ◽  
Univariate Analysis ◽  
Subretinal Fluid ◽  
Choroidal Neovascularisation ◽  
Vascular Endothelial ◽  
Flow Area ◽  
Anti Vegf ◽  
Endothelial Growth Factor

PurposeThe aim of this study was to evaluate the effect of anti-vascular endothelial growth factor (VEGF) therapy on choroidal neovascularisation (CNV) complicating central serous chorioretinopathy (CSC) using multimodal imaging, and to identify possible predictive factors of the treatment response.DesignRetrospective study.MethodsData of 27 eyes with CNV complicating CSC treated with anti-VEGF therapy (either ranibizumab or aflibercept) were reviewed. Response to anti-VEGF treatment was evaluated by change in visual acuity, intra/subretinal fluid modifications and CNV changes on optical coherence tomography angiography (OCTA). Univariate and multivariate analyses were performed to identify predictive factors for central retinal thickness (CRT) change and for the relative degree of treatment response (complete, incomplete or absent fluid reduction).ResultsCRT was significantly reduced at 32±15 days after 2.8±1.3 injections (p=0.0004) as was the subretinal fluid (p=0002). Complete fluid resorption was observed in 45% of cases. Best corrected visual acuity did not significantly improve (p=0.18). CNV area (p=0.09) and CNV flow area (p=0.07) did not significantly decrease. No changes in CNV pattern were noted. Univariate analysis identified greater CRT at baseline (p<0.0001), greater amount of subretinal fluid (p<0.0001), a shorter period of retinal fluid (p=0.04) and female gender (p=0.04) as predictors for CRT reduction. After multivariate analysis the factor of greater CRT at baseline (p<0.0001) proved independent. The degree of treatment response was dependent on the size of CNV surface (p=0.05) and flow area (p=0.05) on OCTA in the univariate analysis, and the latter independent after multivariate analysis. In addition, a shorter time period of retinal fluid appeared to play a role (p=0.01 multivariate, p=0.19 univariate).ConclusionThe anti-VEGF response was highly variable and often incomplete, suggesting that CNV was not solely responsible for the fluid accumulation. Predictive factors may guide indication for anti-VEGF in CNV associated with CSC.

Sign in / Sign up

Export Citation Format

Share Document