Querques Giuseppe, Bux Anna V, Delle Noci Nicola
Department of Ophthalmology, Policlinico Riuniti di Foggia, University of Foggia, Foggia - Italy.
Eur J Ophthalmol. 2009 Sep-Oct;19(5):890-3. doi: 10.1177/112067210901900535.
To describe a patient with nonexudative age-related macular degeneration (AMD) who underwent intravitreal pegaptanib sodium injection for drusenoid pigment epithelium detachment (PED).
A 66-year-old woman, who underwent intravitreal pegaptanib sodium injection in her right eye (RE) for chronic serous drusenoid PED, was submitted to a complete ophthalmologic examination, including fundus biomicroscopy, fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT-3, Humphrey-Zeiss, San Leandro, CA), 3 days and 1 month after the treatment.
Three days after the intravitreal pegaptanib sodium injection, best-corrected visual acuity (BCVA) was 20/32 in the RE. One month later, the patient's BCVA dropped to 20/200 in the RE. Interestingly, fundus biomicroscopy, FA, OCT, and ICGA revealed the development of foveal geographic atrophy. Fundus-related perimetry (MP-1 Micro Perimeter, Nidek Technologies, Padova, Italy) revealed an eccentric and unstable fixation within 2 degrees with central absolute scotoma and pericentral diffuse reduction of sensitivity.
The rapid development of foveal geographic atrophy in our patient may be related to the antivascular endothelial growth factor treatment, in part because of the reduced neuroprotective effect, and in part because of the adjunctive decreased blood flow in an already imbalanced foveal choroidal circulation due to AMD complicated by chronic serous drusenoid PED.
描述一名患有非渗出性年龄相关性黄斑变性（AMD）的患者，该患者因玻璃膜疣状色素上皮脱离（PED）接受了玻璃体内注射培加他尼钠治疗。
一名66岁女性因慢性浆液性玻璃膜疣状PED接受了右眼玻璃体内注射培加他尼钠治疗，在治疗后3天和1个月接受了全面的眼科检查，包括眼底生物显微镜检查、荧光素血管造影（FA）、吲哚菁绿血管造影（ICGA）和光学相干断层扫描（OCT - 3，Humphrey - Zeiss，加利福尼亚州圣莱安德罗）。
玻璃体内注射培加他尼钠3天后，右眼最佳矫正视力（BCVA）为20/32。1个月后，该患者右眼的BCVA降至20/200。有趣的是，眼底生物显微镜检查、FA、OCT和ICGA显示黄斑区地图样萎缩的发展。眼底相关视野检查（MP - 1微型视野计，尼德克技术公司，意大利帕多瓦）显示在2度范围内有偏心且不稳定的注视，中央绝对暗点以及中央周围敏感性弥漫性降低。
我们患者黄斑区地图样萎缩的快速发展可能与抗血管内皮生长因子治疗有关，部分原因是神经保护作用降低，部分原因是由于AMD合并慢性浆液性玻璃膜疣状PED导致黄斑脉络膜循环本已失衡，辅助性血流减少。
