Pandey Neeraj, Guruprasad Ayachit
MM Joshi Eye Institute, Hubli, Karnataka, India.
Clin Ophthalmol. 2010 Oct 5;4:1081-4. doi: 10.2147/OPTH.S13730.
An otherwise healthy 27-year-old woman presented with complaints of sudden painless blurred vision in the right eye for one week. On examination, visual acuity was 20/30 in the right eye and 20/20 in left eye. Fundus examination OS was normal, but OD demonstrated an elevated, opaque, yellowish parapapillary choroidal lesion with grayish membrane associated with minimal subretinal fluid, suggestive of a choroidal neovascular membrane in the center. B-scan ultrasonography revealed findings consistent with a choroidal osteoma. Fundus fluorescein angiography of the right eye revealed a relatively well defined area of hyperfluorescence that increased in size and intensity in the later phases, suggestive of active extrafoveal choroidal neovascular membrane. Optical coherence tomography confirmed the extrafoveal choroidal neovascular membrane with subfoveal fluid. She was treated with intravitreal bevacizumab OD. At the two-week visit, vision OD improved to 20/20. Fluorescein angiography and optical coherence tomography revealed a resolved choroidal neovascular membrane. Intravitreal bevacizumab may be an effective alternative in the management of choroidal neovascular membrane secondary to choroidal osteoma.
一名27岁的健康女性因右眼突发无痛性视力模糊一周前来就诊。检查发现,右眼视力为20/30,左眼视力为20/20。左眼眼底检查正常,但右眼可见视乳头旁脉络膜病变隆起、不透明、呈黄色,伴有灰色膜,视网膜下液极少,提示中央有脉络膜新生血管膜。B超检查结果与脉络膜骨瘤相符。右眼荧光素眼底血管造影显示有一个相对边界清晰的高荧光区,后期大小和强度增加,提示有活动性黄斑外脉络膜新生血管膜。光学相干断层扫描证实了黄斑外脉络膜新生血管膜伴黄斑下积液。右眼给予玻璃体内注射贝伐单抗治疗。两周复诊时,右眼视力提高到20/20。荧光素血管造影和光学相干断层扫描显示脉络膜新生血管膜已消退。玻璃体内注射贝伐单抗可能是治疗脉络膜骨瘤继发脉络膜新生血管膜的一种有效替代方法。