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Intravitreal bevacizumab for treatment of choroidal neovascularization associated with osteogenesis imperfecta.

Rishi P, Rishi E, Venkatraman A - Indian J Ophthalmol (2012 May-Jun)

Bottom Line: She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml).At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200.Considering the natural history of the disease and the increased risk of rupture of the Bruch's membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment.

View Article: PubMed Central - PubMed

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

ABSTRACT
A 12-year-old girl, diagnosed of osteogenesis imperfecta, presented with sudden visual loss in the left eye. Investigations revealed an active choroidal neovascular membrane. She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml). Follow-up at 1 month revealed the development of lacquer crack running through the macula, underlying the fovea. The patient received two re-treatments at 1-month intervals, following which the choroidal neovascularization (CNV) regressed completely. However, further progression of lacquer cracks was noted. At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200. Considering the natural history of the disease and the increased risk of rupture of the Bruch's membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment.

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Related in: MedlinePlus

Active CNV as seen on clinical photography (CP) (a), FFA (b, c) and OCT (d). FFA shows an active subfoveal classic choroidal neovascular membrane with profuse leakage in the late phases. Blocked choroidal fluorescence due to the overlying hemorrhage is also noted. OCT shows subfoveal CNVM and sub-retinal fluid
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Figure 1: Active CNV as seen on clinical photography (CP) (a), FFA (b, c) and OCT (d). FFA shows an active subfoveal classic choroidal neovascular membrane with profuse leakage in the late phases. Blocked choroidal fluorescence due to the overlying hemorrhage is also noted. OCT shows subfoveal CNVM and sub-retinal fluid

Mentions: BCVA was 20/1000 in the right eye and 20/630 in the left. There were no additional findings on biomicroscopic examination in the right eye as compared to the initial visit. Fundus evaluation of the left eye showed the presence of a subfoveal choroidal neovascular membrane (CNVM) [Fig. 1a]. The clinical findings were confirmed on fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). FFA of the left eye revealed an active subfoveal classic CNVM with profuse leakage. Blocked choroidal fluorescence due to the overlying hemorrhage was also noted [Fig. 1b and c]. OCT revealed subfoveal CNVM and sub-retinal fluid [Fig. 1d]. The treatment options were explained and informed consent was obtained. The patient was treated with intravitreal injections of Bevacizumab (1.25 mg/0.05 ml). At 1-month follow-up, the patient had a BCVA of 20/200 in the treated eye. Fundus evaluation showed a yellow-white linear streak deep to the retinal layers, suggestive of lacquer crack [Fig. 2]. The patient received two re-treatments with intravitreal Bevacizumab at 1-month intervals, following which the CNV regressed. At the last follow-up, 6 months following the last injection, the fundus remained stable [Fig. 3] and visual acuity stabilized at 20/200.


Intravitreal bevacizumab for treatment of choroidal neovascularization associated with osteogenesis imperfecta.

Rishi P, Rishi E, Venkatraman A - Indian J Ophthalmol (2012 May-Jun)

Active CNV as seen on clinical photography (CP) (a), FFA (b, c) and OCT (d). FFA shows an active subfoveal classic choroidal neovascular membrane with profuse leakage in the late phases. Blocked choroidal fluorescence due to the overlying hemorrhage is also noted. OCT shows subfoveal CNVM and sub-retinal fluid
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3361825&req=5

Figure 1: Active CNV as seen on clinical photography (CP) (a), FFA (b, c) and OCT (d). FFA shows an active subfoveal classic choroidal neovascular membrane with profuse leakage in the late phases. Blocked choroidal fluorescence due to the overlying hemorrhage is also noted. OCT shows subfoveal CNVM and sub-retinal fluid
Mentions: BCVA was 20/1000 in the right eye and 20/630 in the left. There were no additional findings on biomicroscopic examination in the right eye as compared to the initial visit. Fundus evaluation of the left eye showed the presence of a subfoveal choroidal neovascular membrane (CNVM) [Fig. 1a]. The clinical findings were confirmed on fundus fluorescein angiography (FFA) and optical coherence tomography (OCT). FFA of the left eye revealed an active subfoveal classic CNVM with profuse leakage. Blocked choroidal fluorescence due to the overlying hemorrhage was also noted [Fig. 1b and c]. OCT revealed subfoveal CNVM and sub-retinal fluid [Fig. 1d]. The treatment options were explained and informed consent was obtained. The patient was treated with intravitreal injections of Bevacizumab (1.25 mg/0.05 ml). At 1-month follow-up, the patient had a BCVA of 20/200 in the treated eye. Fundus evaluation showed a yellow-white linear streak deep to the retinal layers, suggestive of lacquer crack [Fig. 2]. The patient received two re-treatments with intravitreal Bevacizumab at 1-month intervals, following which the CNV regressed. At the last follow-up, 6 months following the last injection, the fundus remained stable [Fig. 3] and visual acuity stabilized at 20/200.

Bottom Line: She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml).At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200.Considering the natural history of the disease and the increased risk of rupture of the Bruch's membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment.

View Article: PubMed Central - PubMed

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

ABSTRACT
A 12-year-old girl, diagnosed of osteogenesis imperfecta, presented with sudden visual loss in the left eye. Investigations revealed an active choroidal neovascular membrane. She underwent treatment with intravitreal Bevacizumab (1.25 mg/0.05 ml). Follow-up at 1 month revealed the development of lacquer crack running through the macula, underlying the fovea. The patient received two re-treatments at 1-month intervals, following which the choroidal neovascularization (CNV) regressed completely. However, further progression of lacquer cracks was noted. At the last follow-up, 6 months following the last injection, the fundus remained stable and vision was maintained at 20/200. Considering the natural history of the disease and the increased risk of rupture of the Bruch's membrane in such eyes, the possible complication of a lacquer crack developing must be borne in mind, before initiating treatment.

Show MeSH
Related in: MedlinePlus