scholarly journals Case Report: A Case of Cotton-Wool Spots After Intravitreal Injection of Conbercept in an Infant With Incontinentia Pigmenti

2021 ◽  
Vol 8 ◽  
Author(s):  
Licong Liang ◽  
Yiliu Yang ◽  
Shaochong Bu ◽  
Fang Lu
Keyword(s):  
Case Report ◽  
Intravitreal Injection ◽  
Laser Photocoagulation ◽  
Retinal Ischemia ◽  
Artery Occlusion ◽  
Incontinentia Pigmenti ◽  
Cotton Wool ◽  
Cotton Wool Spots ◽  
Ophthalmic Manifestations ◽  
Anti Vegf

Introduction: Incontinentia pigmenti (IP) is a rare X-linked neuroectodermal dysplasia affecting multiple organs. One of its most significant ophthalmic manifestations is retinal neovascularization due to retinal ischemia, which has been traditionally treated with laser photocoagulation or cryotherapy. The application of anti-vascular endothelial growth factor (VEGF) has been reported for the treatment of retinopathy of IP with beneficial results. However, clinicians should be aware of the possible ocular and systemic side effects of the intravitreal injection of anti-VEGF agents.Case Report: A 4-month-old female infant with IP was treated with intravitreal injection of conbercept in both eyes. However, cotton-wool spots were noticed in the left eye 1 week after the injection. Laser photocoagulation was performed as an adjunct treatment. The cotton-wool spots were absorbed 1 month after the first intravitreal injection and have eventually disappeared.Discussion: The cotton-wool spots, after intravitreal injection of conbercept for the treatment of IP, indicated severe retinal ischemia resulting from the neutralization of excessive VEGF, which was shown on fundus photograph and fluorescent angiography. Anti-VEGF agents could cause retinal arteriolar vasoconstriction and artery occlusion on rare occasions. The administration of anti-VEGF agents in pediatric cases with severe neovascularization and retinal ischemia should be carefully considered.

scholarly journals X-Linked Retinoschisis and a Coats-Like Response in the Setting of Retinopathy of Prematurity

2020 ◽  
Vol 4 (6) ◽  
pp. 525-529
Author(s):  
Kenneth C. Fan ◽  
Mark A. McAllister ◽  
Nicolas A. Yannuzzi ◽  
Nimesh A. Patel ◽  
Supalert Prakhunhungsit ◽  
...  
Keyword(s):  
Case Report ◽  
Young Patient ◽  
Retinopathy Of Prematurity ◽  
Laser Photocoagulation ◽  
Imaging Findings ◽  
Unique Combination ◽  
Unique Case ◽  
Anti Vegf ◽  
History Of

Purpose: This case report describes a unique case of a young patient with retinopathy of prematurity (ROP), a unilateral Coats-like response, and X-linked retinoschisis (XLRS). Methods: A 9-year-old boy with a history of regressed ROP presented with a unilateral Coats-like response, subretinal exudation, and XLRS. Examination and imaging findings demonstrated a highly unique combination of bilateral retinoschisis and a dramatic unilateral Coats-like response with a large schisis cavity. Results: Treatment with laser photocoagulation and anti-VEGF therapy led to resolution of the subretinal exudative changes. Conclusions: This is the first published description to our knowledge of a patient with a Coats-like response, XLRS, and a history of regressed ROP with resolution after treatment.

scholarly journals Treating corneal neovascularization using a combination of anti-VEGF injection and argon laser photocoagulation application - case report

2021 ◽  
Vol 65 (3) ◽  
pp. 286-289
Author(s):  
Mariela Grossi Donato ◽  
Elias Donato ◽  
Marina Álvares de Campos Cordeiro ◽  
Matheus Martins de Andrade ◽  
João Alberto Holanda de Freitas
Keyword(s):  
Case Report ◽  
Laser Photocoagulation ◽  
Argon Laser ◽  
Corneal Neovascularization ◽  
Anti Vegf ◽  
Argon Laser Photocoagulation

scholarly journals A rare case report of Coats’ disease

2020 ◽  
Vol 5 (7) ◽  
pp. 194-199
Author(s):  
Dr. Vedesh Madan Kulkarni ◽  
◽  
Dr. Milind Madhukar Sabnis ◽  
Dr. Hardik Kailashbhai Kalaria ◽  
Dr. Himali Vivek Agarwal ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Features ◽  
Laser Photocoagulation ◽  
Rare Case ◽  
Vision Loss ◽  
Retinal Ischemia ◽  
Rare Case Report ◽  
Coats Disease ◽  
Idiopathic Disease ◽  
Systemic Associations

Coats’ disease was first described by George Coats, as a unilateral retinal vascular abnormality.Coats’ disease is a nonhereditary, idiopathic disease presenting with vascular telangiectasia withintraretinal and subretinal exudation with no racial preponderance and systemic associations. Coats’disease presents with a wide ambit of clinical features- vision loss, strabismus, leukocoria, ornystagmus. The three classical features that are pathognomonic of Coats’ are exudative retinaldetachment, telangiectatic vessels, and peripheral retinal ischemia. The modalities for treatment ofCoats disease that can be used are laser photocoagulation, anti-VEGF agents, or a combination ofboth and cryotherapy. This article describes a case report of a 10-year-old male child withcomplaints of painless loss of vision, his ophthalmological evaluation, and the treatment isundertaken.

scholarly journals Combination of Navigated Macular Laser Photocoagulation and Anti-VEGF Therapy: Precise Treatment for Macular Edema under Dry Retinal Conditions

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Ernest V. Boiko ◽  
Dmitrii S. Maltsev
Keyword(s):  
Macular Edema ◽  
Intravitreal Injection ◽  
Laser Photocoagulation ◽  
Scanning Laser ◽  
Scanning Laser Ophthalmoscopy ◽  
Anti Vegf ◽  
Group 2 ◽  
Laser Burn ◽  
Group 1

Purpose. To compare the controllability of navigated macular laser photocoagulation (MLP) in dry versus edematous retina and validate that pretreatment diagnostic images can be used as basis for navigated MLP after the macular edema (ME) has been resolved.Materials and Methods. Group 1 was divided into subgroup 1 (dry retina MLP) and subgroup 2 (MLP in ME) for comparisons of laser-burn diameters. In group 2, the areas and locations of ME before an intravitreal injection of anti-VEGF (IVAV) were compared with those of recurrent ME.Results. The average actual diameter as percentage of planned diameter of laser burn in subgroup 1 (11 DME eyes, 6 BRVO eyes) versus subgroup 2 (5 DME eyes, 8 BRVO eyes) was 115.1 ± 9.1% versus 167.2 ± 13.8% (based on retro-mode scanning laser ophthalmoscopy), and 118.1 ± 14.8% versus 176.1 ± 11.6% (based on OCT) (p<0.001). In group 2 (6 DME eyes, 6 BRVO eyes), difference in mean ME area before IVAV and that in recurrent edema was insignificant (p>0.05).Conclusion. The controllability of navigated MLP in dry retina is improved compared to edematous retina. This study validates that pretreatment diagnostic images can be used as basis for navigated MLP after the edema has been resolved.

scholarly journals Non-arteritic anterior ischemic optic neuropathy with Cilioretinal artery occlusion: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ya-Yun Yang ◽  
Ming-Shan He
Keyword(s):  
Intravitreal Injection ◽  
Optic Neuropathy ◽  
Retinal Ischemia ◽  
Artery Occlusion ◽  
Anterior Ischemic Optic Neuropathy ◽  
Ischemic Optic Neuropathy ◽  
Cilioretinal Artery Occlusion ◽  
Cilioretinal Artery ◽  
Retinal Artery ◽  
The Right

Abstract Background To describe a peculiar case of concurrent non-arteritic anterior ischemic optic neuropathy (NAION) and cilioretinal arteries occlusion (CLRAO) without other causative agents which responded well to intravenous and intravitreal injection of corticosteroids. Case presentation A 41-year-old woman presented with painless vision loss in the right eye for 1 week. Fundus examinations showed marked disc swelling, flame-shaped hemorrhage over the superior nerve fiber area, and well-demarcated retinal ischemia superior to the fovea in the right eye. Under the impression of NAION with branch retinal artery occlusion, the patient was treated with intravenous and intravitreal injection of corticosteroids. Two months later, as the disc swelling and retinal ischemia resolved, we found that the occluded artery was the cilioretinal artery and not the ordinary branch retinal artery. Conclusions CLRAO may be concomitant with the setting of NAION, the physicians should be aware that CLRAO may be misinterpreted as BRAO owing to profound disc edema during the early stages of the disease.

scholarly journals Occlusive retinal vasculopathy with macular branch retinal artery occlusion as a leading sign of atypical hemolytic uremic syndrome – a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Pérez González ◽  
Matias Iglicki ◽  
Shuli Svetitsky ◽  
Yaeli Bar-On ◽  
Zohar Habot-Wilner ◽  
...  
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Retinal Artery Occlusion ◽  
Retinal Ischemia ◽  
Artery Occlusion ◽  
Acute Onset ◽  
Panretinal Photocoagulation ◽  
Branch Retinal Artery Occlusion ◽  
Uremic Syndrome ◽  
Retinal Artery

Abstract Background Hemolytic Uremic Syndrome (HUS) is a rare disorder characterized by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure, considered within the group of thrombocytic microangiopathies. Ocular complications in HUS are very rare. Here, we report an adult patient who suffered from acute onset of paracentral scotoma, caused by branch retinal artery occlusion (BRAO), as a leading symptom of atypical HUS. Case presentation A 39-year-old healthy male was lately diagnosed with essential hypertension and mild renal impairment. He complained about acute onset of central scotoma in his left eye. Fundus examination revealed marked narrowing of retinal vessels, cotton wool spots and few retinal hemorrhages in both eyes. The patient was diagnosed with bilateral ischemic retinal vasculopathy and acute macular BRAO in his left eye. Workup revealed thrombocytopenia, worsening renal failure. Renal biopsy showed signs of chronic thrombotic microangiopathy. The patient was diagnosed with atypical HUS (aHUS) and started on plasmapheresis, together with eculizumab. As his condition continued to worsen, he was put on renal replacement therapy. Due to a persistent monoclone of IgG1, the patient underwent bone marrow biopsy which revealed Monoclonal Gammopathy of renal significance, triggering a HUS and treatment was initiated accordingly. Two months after initial presentation, the patient developed neovascularization of the optic disc (NVD) in his left eye, and was treated with 3 monthly intravitreal bevacizumab injections with complete regression of the NVD. The patient suffered from myocardial infarction in the later course and was lost for follow-up. He returned 11 months after the last bevacizumab injection because of sudden loss of vision in his left eye caused by a dense vitreous hemorrhage. Biomicroscopy revealed a new NVD in his right eye. The patient underwent panretinal photocoagulation in both eyes with regression of neovascularization. Vision improved and remained 20/20 in both eyes. Conclusion We present a case report showing retinal ischemia can be linked with aHUS. As clinal diagnosis might be challenging, physicians should be aware of the rare ocular manifestations of this devastating multi-organ disease. In case of retinal ischemia, panretinal photocoagulation should be initiated soon to avoid blinding complications.

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