Intravitreal ranibizumab for the treatment of choroidal neovascularization secondary to ocular toxoplasmosis

Shah, Nikunj J; Shah, Urmi

doi:10.4103/0301-4738.82005

Cited by 18 publications

(17 citation statements)

References 5 publications

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“…Options to treat CNVM secondary to resolved Toxoplasma retinitis include observation, corticosteroids, laser photocoagulation [ 15 ], photodynamic therapy (PDT) [ 16 ], submacular surgery [ 17 ], and intravitreal anti-VEGF agents [ 15 , 18 ]. Management of CNVM in cases of healed toxoplasmosis with anti-VEGFs has been associated with reactivation of the retinochoroiditis lesion, so few authors do recommend concomitant use of oral anti- Toxoplasma treatment as prophylaxis [ 19 ].…”

Section: Resultsmentioning

confidence: 99%

Coexisting choroidal neovascularization and active retinochoroiditis—an uncommon presentation of ocular toxoplasmosis

Hegde

Relhan²,

Pathengay

et al. 2015

J Ophthal Inflamm Infect

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BackgroundChoroidal neovascularization during the active stage of Toxoplasma retinochoroiditis is an uncommon clinical presentation. The authors retrospectively reviewed medical charts of patients with coexisting choroidal neovascular membrane and active Toxoplasma retinochoroiditis.FindingsThree patients presented with coexisting choroidal neovascular membrane and active Toxoplasma retinochoroiditis. All lesions had adjacent subretinal hemorrhage. The diagnosis was confirmed based on clinical presentation, fundus fluorescein angiography (FFA), and optical coherence tomography (OCT) findings. The patients were managed with a combination of treatments including intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF), oral anti-Toxoplasma treatment, and oral corticosteroids. In all patients, the retinitis lesion resolved in 6 weeks and the coexisting choroidal neovascular membrane resolved over 6 to 12 weeks.ConclusionsRecurrences in Toxoplasma retinochoroiditis are common as satellite lesions adjacent to an old atrophic scar. Coexisting choroidal neovascularization with active Toxoplasma retinochoroiditis is an important presentation and should be suspected in the presence subretinal hemorrhage and managed with a combination of anti-Toxoplasma treatment and intravitreal anti-VEGF.

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Section: Resultsmentioning

confidence: 99%

Coexisting choroidal neovascularization and active retinochoroiditis—an uncommon presentation of ocular toxoplasmosis

Hegde

Relhan²,

Pathengay

et al. 2015

J Ophthal Inflamm Infect

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“…Shah ve ark. 8 sundukları 18 yaşında toksoplazma koryoretinit skarına ikincil KNVM gelişen olguda, tek doz ranibizumab intravitreal enjeksiyonu sonrası hem görme keskinliğinde artış olmuş, hem de fundus floresein anjiyografi ve OKT'de bulgularda düzelme izlenmiştir.…”

Section: Discussionunclassified

“…9 Önceki olgu sunumlarında da tedavi sonrası görme keskinliğinde artış ve lezyonda gerileme olmuşsa da tam remisyon izlenmemiştir. 5,6,8 Bizim olgumuzda intravitreal bevacizumab enjeksiyonu sonrası KNVM'de kısmi düzelme olmakla birlikte görme keskinliğinde artış tespit edilmiştir. Benzer şekilde yaşa bağlı KNVM'de yapılan çalışmalarda da subfoveal skar varlığında anti-VEBF intravitreal enjeksiyonlarının kısmi yararı olduğu bildirilmiştir.…”

Section: Discussionunclassified

Toksoplazma Koryoretinitine İkincil Koroidal Neovasküler Membran Olgusunda İntravitreal Bevacizumab Enjeksiyon Tedavisi

Güngör¹,

Akkoyun²,

Şingar³

et al. 2014

tjo

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Elli yedi yaşında erkek hasta sol gözde görme kaybı ile başvurdu ve inaktif toksoplazma koryoretinit skarına ikincil koroidal neovasküler membran tanısı konuldu. Hastaya intravitreal bevacizumab enjeksiyonu uygulandı. Koroidal neovasküler membran kısmi olarak geriledi ve görme keskinliği 1/10'dan 3/10'a yükseldi. İntravitreal bevacizumab, toksoplazma koryoretinitlerine ikincil koroidal neovasküler membranların tedavisinde etkin görünmektedir. (Turk J Ophthalmol 2014; 44: 237-9) Anah tar Ke li me ler: Koroidal neovasküler membran, toksoplazma koryoretiniti, bevacizumab A 57-year-old male patient presenting with visual loss in the left eye was diagnosed as choroidal neovascular membrane secondary to inactive toxoplasmosis retinochoroiditis scar. He underwent intravitreal bevacizumab injection as primary therapy. The choroidal neovascular membrane regressed partially and the initial visual acuity improved from 1/10 to 3/10. Intravitreal bevacizumab injection appears to be effective in the treatment of choroidal neovascular membrane secondary to toxoplasma retinochoroiditis.

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“…Dobrý efekt byl rovněž popsán po intravitreální aplikaci anti-VEGF preparátů pravděpodobně proto, že VEGF (vaskulární endotelový růstový faktor), zde hraje roli nejenom v procesu neoangiogeneze a tedy tvorbě neovaskulární membrány, ale také jako prozánětlivý mediátor [11]. Ke zlepšení sítnicového nálezu došlo po aplikaci bevacizumabu (Avastinu nás se jedná o off-label terapii) [16], ranibizumabu [20] či afliberceptu (jedná se o pilotní studii) [11].…”

Section: Diskuseunclassified

Congentinal Central Toxoplasma Chorioretinitis - Case Study

Maršolková¹,

Timkovič

Němčanský

et al. 2018

CSO

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Kongenitální toxoplasmosa je celosvětově rozšířené onemocnění způsobené transplacentárním přenosem intracelulárního parazita Toxoplasma gondii. V případě vertikálního přenosu může infekce způsobit závažné multiorgánové komplikace až úmrtí plodu v závislosti na fázi těhotenství v okamžiku nákazy a na celkovém stavu imunitního systému matky. Z příznaků je známá častá triáda chorioretinitida, hydrocefalus a intrakraniální kalcifikace. Právě toxoplasmová chorioretinitida je jejím nejčastějším očním projevem a v případě zasažení centrální oblasti sítnice může vést k závažnému postižení centrální zrakové ostrosti nebo až ke slepotě dítěte. V současné době je v České republice prenatální screening tohoto onemocnění dobrovolný. Práce dokumentuje případ chorioretinitidy toxoplasmové etiologie u novorozeného chlapce zachycené v aktivním stádiu a vývoj sítnicového nálezu v čase. Dále se věnuje celkovým multiorgánovým komplikacím popsaným u tohoto pacienta, kdy na základě diagnostikovaného hydrocefalu bylo indikováno oční vyšetření, které stanovilo závažné změny na očním pozadí. Hydrocefalus u chlapce byl následně řešen. V textu práce je popsán stručný souhrn dostupných diagnostických a terapeutických metod a možnosti screeningu onemocnění v porovnání s jinými zeměmi.

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Intravitreal ranibizumab for the treatment of choroidal neovascularization secondary to ocular toxoplasmosis

Cited by 18 publications

References 5 publications

Coexisting choroidal neovascularization and active retinochoroiditis—an uncommon presentation of ocular toxoplasmosis

Coexisting choroidal neovascularization and active retinochoroiditis—an uncommon presentation of ocular toxoplasmosis

Toksoplazma Koryoretinitine İkincil Koroidal Neovasküler Membran Olgusunda İntravitreal Bevacizumab Enjeksiyon Tedavisi

Congentinal Central Toxoplasma Chorioretinitis - Case Study

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