Alexandrite Laser-Induced Choroidal Neovascularization Successfully Treated With Aflibercept

Diafas, Asterios; Stampouli, Despoina; Dastiridou, Anna; Androudi, Sofia; Brazitikos, Periklis

doi:10.7759/cureus.8294

Cited by 4 publications

(4 citation statements)

References 15 publications

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“…As a consequence of chorioretinal anastomoses, in some cases, choroidal neovascular membranes may develop. 10,11 In the current case, no signs of choroidal neovascularisation were evident during six months.…”

Section: Np56mentioning

confidence: 47%

Chorioretinal anastomosis secondary to inadvertent alexandrite laser exposure

Simsek

Özçalışkan

Pehlivanoğlu

et al. 2023

European Journal of Ophthalmology

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Introduction Alexandrite laser is generally used for hair removal and treatment of hyperpigmented skin lesions. It is important to use protective equipment during treatment. In previous cases, complications such as conjunctival hyperemia, anterior uveitis, and choroidal neovascularization were reported. We report a case who developed chorioretinal anastomosis secondary to inadvertent alexandrite laser exposure. Case description A 44 year-old woman presented with decrease of vision in the left eye. She had an history of alexandrite laser treatment for facial hair removal two weeks ago. Fundus examination of the left eye revealed an elevated yellowish lesion in the temporal macula and retina pigment epithelium (RPE) atrophy was observed in the inferotemporal perifoveal region. Optical coherence tomography (OCT) of the left eye revealed the disorganization of inner and outer retinal layers, a rupture in the Bruch membrane, and an absence of RPE. Fluorescein angiography images showed early hyperfluoresence inferior to the fovea. OCT angiography revealed an abnormal vascular network between deep retina layers and choroid. B-scan with flow overlay demonstrated the blood flow in the abnormal vascular network which is suggestive of chorioretinal anastomosis. The patient was followed monthly for choroidal neovascularization development. Six months after laser exposure the best corrected visual acuity was partially improved in the left eye and fundus examination showed pigmentary changes. Conclusion Chorioretinal anastomosis may rarely develop secondary to inadvertent alexandrite laser treatment. It is important to use protective equipment during treatment to prevent ophthalmological complications.

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Section: Np56mentioning

confidence: 47%

Chorioretinal anastomosis secondary to inadvertent alexandrite laser exposure

Simsek

Özçalışkan

Pehlivanoğlu

et al. 2023

European Journal of Ophthalmology

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“…Several studies reported similar results for the use of IVA in cases of CNV secondary to trauma, laser-induced retinal injury, uveitis, and hereditary disorders. Diafas et al [ 9 ] reported a complete resolution of CNV secondary to laser pointer injury using a single IVA injection. They had no recurrences over 38 months of follow-up.…”

Section: Discussionmentioning

confidence: 99%

A customized regimen of intravitreal aflibercept for the treatment of choroidal neovascularization secondary to different chorioretinal diseases

et al. 2023

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Background To assess the response of CNV secondary to chorioretinal diseases to IVA and to explore the adequate dosing regimen and the long-term results. Methods A retrospective study including patients with treatment-naïve active CNV secondary to chorioretinal diseases. All patients received an initial IVA injection followed by a PRN regimen. The main outcome measures were improvement of BCVA, improvement of anatomical morphology and vascularity of the CNV on SS-OCT, and SS-OCTA, respectively, and ocular or systemic complications attributed to IVA. Results The study included 17 eyes of 15 patients. Nine patients (60%) were females. The median age was 20 years. The main primary chorioretinal disease was vitelliform macular dystrophy (29%). The mean baseline BCVA was 0.16. The mean follow-up period was 15 months. Final BCVA improved by a mean of 6 lines. The CNV regressed or became inactive in all eyes. The median number of IVA injections was 2. There were no ocular or systemic complications attributed to IVA. Conclusion The customized IVA regimen is effective in inducing long-term regression of secondary CNV and in improving BCVA. Multimodal imaging is fundamental in establishing the diagnosis of CNV, and in monitoring its response to IVA.

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“…Laser operators should report novel adverse events in the literature and share them with the medical community. 107 -139…”

Section: Discussionmentioning

confidence: 99%

Adverse Events of Light-Assisted Hair Removal: An Updated Review

et al. 2023

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Background With light-assisted hair removal becoming widely used, reports of adverse effects are increasing. Objective To review all the reported optical incidents and cutaneous complications of laser or intense pulse light-assisted hair removal. Methods A PubMed database systematic search was performed to identify studies reporting such adverse events before July 2022 using the Mesh terms “adverse effects” AND “hair removal” AND (“laser” OR “intense pulse light”). Results Altogether, 358 references were identified. After excluding duplicates, unrelated articles, guidelines, and conference abstracts, then adding references from studies bibliography, 104 publications were included. Ocular incidents consisted of anterior uveitis, iritis and iris atrophy, pupillary distortion, posterior synechiae, anterior chamber pigment, and cataracts in the anterior subcapsular region. Cutaneous complications consisted of pain, burns, folliculitis, leukotrichia, paradoxical hypertrichosis, pigmentary changes, changes in nevi, pili bigemini, herpes infection, hyperhidrosis, bromhidrosis, Fox-Fordyce disease, and frostbite from the cooling system. They were mostly correlated to skin type and body area as well as to light device and set parameters. Intense pulse light devices were found to be less painful than alexandrite laser, yet more painful than diode laser; Nd:YAG laser had the highest pain score. Conclusion Optical incidents can be systematically avoided. Cutaneous complications are usually related to professional errors and patient characteristics. Better knowledge of laser physics and adequate training of laser operators are key recommendations to avoid undesirable side effects. Safety recommendations help prevent most of the reported complications.

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Alexandrite Laser-Induced Choroidal Neovascularization Successfully Treated With Aflibercept

Cited by 4 publications

References 15 publications

Chorioretinal anastomosis secondary to inadvertent alexandrite laser exposure

Chorioretinal anastomosis secondary to inadvertent alexandrite laser exposure

A customized regimen of intravitreal aflibercept for the treatment of choroidal neovascularization secondary to different chorioretinal diseases

Adverse Events of Light-Assisted Hair Removal: An Updated Review

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