Ostre pogorszenie ostrości wzroku z naczyniówkową hypoperfuzją po terapii fotodynamicznej - opis przypadku

Abstract

SummaryBackgroundPhotodynamic therapy (PDT) is considered a selective method of treatment which works in areas of choroidal neovascularization (CNV); however, there are reports of choroidal hypoperfusion after PDT. This paper presents a clinical case of choroidal circulation disturbances caused by PDT, accompanied by CNV progression.Case ReportThe patient, a 75-year-old woman, was qualified for PDT in the right eye – first treatment due to progression of occult CNV. Best corrected visual acuity (BCVA) in the right eye at baseline was +0.3 logMAR. After PDT, a rapid decrease in visual acuity to +0.7 logMAR in the right eye was observed, central choroidal hypoperfusion in fluorescein angiography (FA) with subretinal fluid appeared and, as a consequence, progression of neovascular age-related macular degeneration (AMD). After stabilizing the local state through conservative therapy, a decision was made to treat the right eye with intravitreal injections of vascular endothelial growth factor (VEGF) inhibitor. During a 12-month period of observation, 7 doses of ranibizumab were administered. A regression in activity of wet AMD was observed, with visual acuity of +0.6 logMAR.ConclusionsChoroidal circulation disturbance after PDT is possible and has to be taken into account. Sporadically, it can lead to an acute decrease in visual acuity and local state. After stabilization of AF and optical coherence tomography imaging, further treatment of neovascular AMD with intravitreal injections of anti-VEGF agents should be considered.

Acute Exudative Maculopathy and Bacillary Layer Detachment in Patients With Central Serous Chorioretinopathy After Photodynamic Therapy

“…Because PAEM is not a well-known complication and there is a lack of large series, management of PAEM differs from observation to different treatments such as steroids (topical, systemic, or intravitreal) or anti-VEGF. 11,12,25–28 In the study by Manayath et al, 11 all cases of PAEM resolved promptly and completely with most of the patients receiving anti-VEGF injections within 2 days after PDT, as part of the combination therapy in PCV, and only one eye was observed. This combination treatment could have an impact on the faster resolution of exudation.…”

Safety and Effectiveness of Intravitreal Brolucizumab Injection in Combination With Sub-Tenon's Capsule Triamcinolone Acetonide Injection for Polypoidal Choroidal Vasculopathy During the Loading Phase

“…Combining ranibizumab with photodynamic therapy has been reported to improve polyp occlusion rates by 71.4% in EVEREST II at three months [11]. However, photodynamic therapy carries risks such as bleeding, choroidal hypoperfusion, and atrophy [34][35][36][37]. In previous studies using brolucizumab, Matsumoto et al ( 2021) [29], Matsumoto et al…”

“…Concerns related to STTA use include potential increases in IOP, long-term risks of cataracts, and infections [ 35 , 47 ]. Previous studies using brolucizumab in combination with STTA have reported a 10% incidence of transient IOP increase following STTA administration, which resolved without the need for additional drug therapy [ 30 ].…”

Oxymatrine impedes the progression of endotoxin‐induced glaucoma via redox system modulations

“…Neuroinflammation is the hallmark of several ocular disorders and one of the primary causes of glaucoma progression, mainly uveitic glaucoma which is mediated via programmed retinal ganglion cell (RGCs) death along with simultaneous axonal decadence at the lamina cribrosa region of the optic nerve at the lamina cribrosa region. [ 1–7 ] This condition, also known as the “silent thief of sight,” is triggered by a steep rise in inflammatory mediators, changes in the trabecular meshwork (TM), disruption of the neurotropic supply, elevated stress levels, and dysregulations of the ATPases in the retinal layers. Mechanobiological alterations at the ocular front are vital in this process.…”