Aims: To report the beneficial effect of intravitreal bevacizumab (Avastin) injection in patients with acute central serous chorioretinopathy. Methods: Ten eyes of 10 patients with acute central serous chorioretinopathy received an intravitreal bevacizumab (1.25 mg/0.05 ml) injection. At baseline and follow-up visits patients had best corrected visual acuity (BCVA), IOP assessment, dilated fundus examination and OCT imaging. Main outcome measures were the resolution of neurosensory detachment, improvement in visual symptoms and visual acuity. Results: All patients showed resolution of neurosensory detachment promptly, and improvement in visual acuity and symptoms within 1 month. In 1 case, fluorescein leakage resolved and neurosensory detachment nearly resolved at 2 weeks after treatment. At 6 months the mean BCVA (LogMAR) had improved from 0.32 to 0.04, which was statistically significant (p = 0.007, Wilcoxon signed ranks test). No recurrence was observed during a 6-month follow-up. Conclusions: Intravitreal bevacizumab injection for acute central serous chorioretinopathy may result in prompt resolution of neurosensory detachment and reduction of angiographic leakage. These short-term results suggest that intravitreal bevacizumab injection may constitute a promising therapeutic option in acute central serous chorioretinopathy.
LETTERS 277 cortex of hypermature lenses than in immature lenses. 4 In the case presented here, we speculated that the accumulated lobules of LEP embedded the retained lens material and kept it from breaking into small pieces, releasing soluble lens protein, and avoiding strong chemotactic activity for monocytes. 5 As time went by, the lens protein denatured to plentiful HMWP, and abundant macrophages laden with digested lens material fi nally led to the glaucoma.As for the right eye, the Soemmering's ring cataract had a hybrid content of retained lens material and LEP. It was diffi cult to eradicate the content only without also removing the capsule. Although en bloc excision of the after-cataract and simple PPV were performed, some complications still occurred, such as retained fragments, glaucoma, and endothelial injury. Fortunately, the second operation led to good results, including visual improvement. However, the left eye revealed no visual improvement owing to the long duration of elevated IOP.From this case, we learned that lens material-induced glaucoma might occur 25 years after cataract extraction. With fi ndings of severe LEP and aqueous cytology, radical and immediate surgical intervention should be performed to eliminate further visual loss.
PurposeTo report a case of cancer-associated nummular loss of the retinal pigment epithelium.MethodsA 47-year-old man with a history of hepatocellular carcinoma presented with three weeks of bilateral visual loss. His best-corrected visual acuity was 20/40 in each eye. He had multiple round confluent grayish-brown patches at the level of retinal pigment epithelium, and no pigmented choroidal lesions. Fluorescein angiography showed circular areas of transmission defect and indocyanine green angiography showed early hyperfluorescence, corresponding with the multiple round confluent patches.ConclusionsWe report a case of visual paraneoplastic syndrome which showed nummular loss of the pigment epithelial cells which distinguishes the clinical component of BDUMP syndrome.
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