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Ranibizumab for choroidal neovascular membrane in a rare case of Bietti's crystalline dystrophy: a case report.

Nachiappan K, Krishnan T, Madhavan J - Indian J Ophthalmol (2012 May-Jun)

Bottom Line: We report a rare case of Bietti's crystalline dystrophy presenting with choroidal neovascular membrane (CNVM) which was treated with three injections of intravitreal ranibizumab.The CNVM underwent scarring after the injections with stabilization of visual acuity at a follow-up period of 12 months suggesting that intravitreal ranibizumab may have a role in the management of CNVM in these rare cases.

View Article: PubMed Central - PubMed

Affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, 18, College Road, India.

ABSTRACT
We report a rare case of Bietti's crystalline dystrophy presenting with choroidal neovascular membrane (CNVM) which was treated with three injections of intravitreal ranibizumab. The CNVM underwent scarring after the injections with stabilization of visual acuity at a follow-up period of 12 months suggesting that intravitreal ranibizumab may have a role in the management of CNVM in these rare cases.

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Related in: MedlinePlus

Color fundus photograph 12 months after the last injection in the left eye shows scarred choroidal neovascular membrane in the right eye (a) and left eye (b) which is also demonstrated on OCT (c, d). mfERG (e, f) showed grossly reduced central and paracentral responses and central visual field defects were noted on HVF (g, h)
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Figure 2: Color fundus photograph 12 months after the last injection in the left eye shows scarred choroidal neovascular membrane in the right eye (a) and left eye (b) which is also demonstrated on OCT (c, d). mfERG (e, f) showed grossly reduced central and paracentral responses and central visual field defects were noted on HVF (g, h)

Mentions: Full-field Electroretingram ERG showed grossly normal photopic and scotopic responses while multifocal ERG revealed grossly reduced central and paracentral ring responses in both eyes [Figs. 1g and h]. Humphrey visual fields 30–2 showed dense central scotoma in both the eyes [Figs. 1i and j]. His serum triglyceride level was found to be 171 mg/dl. Genetic workup was also done and bidirectional sequencing of all eleven exons of CYP4V2 gene did not reveal any pathogenic variation. The patient was explained the nature of his condition. A treatment option of anti-VEGF (Vascular Endothelial Growth Factor) injection was offered to the patient after explaining its roles and limitations for which the patient consented. He was administered three injections of 0.05 mg ranibizumab (Lucentis®; Novartis Pharma AG, Basel, Switzerland; Genentech Inc., South San Francisco, CA, USA) intravitreally at monthly intervals. At the last follow-up of 12 months after the final injection the patient maintained the same visual acuity and distortion had reduced. Fundus examination showed scarred CNVM in both eyes [Figs. 2a and b] which was confirmed on OCT [Figs. 2c and d]. The multifocal ERG [Figs. 2e and f] and visual fields [Figs. 2g and h] did not show much variation over the period of follow-up.


Ranibizumab for choroidal neovascular membrane in a rare case of Bietti's crystalline dystrophy: a case report.

Nachiappan K, Krishnan T, Madhavan J - Indian J Ophthalmol (2012 May-Jun)

Color fundus photograph 12 months after the last injection in the left eye shows scarred choroidal neovascular membrane in the right eye (a) and left eye (b) which is also demonstrated on OCT (c, d). mfERG (e, f) showed grossly reduced central and paracentral responses and central visual field defects were noted on HVF (g, h)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3361816&req=5

Figure 2: Color fundus photograph 12 months after the last injection in the left eye shows scarred choroidal neovascular membrane in the right eye (a) and left eye (b) which is also demonstrated on OCT (c, d). mfERG (e, f) showed grossly reduced central and paracentral responses and central visual field defects were noted on HVF (g, h)
Mentions: Full-field Electroretingram ERG showed grossly normal photopic and scotopic responses while multifocal ERG revealed grossly reduced central and paracentral ring responses in both eyes [Figs. 1g and h]. Humphrey visual fields 30–2 showed dense central scotoma in both the eyes [Figs. 1i and j]. His serum triglyceride level was found to be 171 mg/dl. Genetic workup was also done and bidirectional sequencing of all eleven exons of CYP4V2 gene did not reveal any pathogenic variation. The patient was explained the nature of his condition. A treatment option of anti-VEGF (Vascular Endothelial Growth Factor) injection was offered to the patient after explaining its roles and limitations for which the patient consented. He was administered three injections of 0.05 mg ranibizumab (Lucentis®; Novartis Pharma AG, Basel, Switzerland; Genentech Inc., South San Francisco, CA, USA) intravitreally at monthly intervals. At the last follow-up of 12 months after the final injection the patient maintained the same visual acuity and distortion had reduced. Fundus examination showed scarred CNVM in both eyes [Figs. 2a and b] which was confirmed on OCT [Figs. 2c and d]. The multifocal ERG [Figs. 2e and f] and visual fields [Figs. 2g and h] did not show much variation over the period of follow-up.

Bottom Line: We report a rare case of Bietti's crystalline dystrophy presenting with choroidal neovascular membrane (CNVM) which was treated with three injections of intravitreal ranibizumab.The CNVM underwent scarring after the injections with stabilization of visual acuity at a follow-up period of 12 months suggesting that intravitreal ranibizumab may have a role in the management of CNVM in these rare cases.

View Article: PubMed Central - PubMed

Affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, 18, College Road, India.

ABSTRACT
We report a rare case of Bietti's crystalline dystrophy presenting with choroidal neovascular membrane (CNVM) which was treated with three injections of intravitreal ranibizumab. The CNVM underwent scarring after the injections with stabilization of visual acuity at a follow-up period of 12 months suggesting that intravitreal ranibizumab may have a role in the management of CNVM in these rare cases.

Show MeSH
Related in: MedlinePlus