Loukianou Eleni, Kisma Nacima, Hamilton Robin
Moorfields Eye Hospital, London, UK.
Case Rep Ophthalmol. 2010 Dec 8;1(2):110-3. doi: 10.1159/000321730.
To describe a patient with a giant pigment epithelial detachment (PED) secondary to exudative age-related macular degeneration (ARMD) successfully treated with a single intravitreal ranibizumab (Lucentis) injection (0.5 mg/0.05 ml).
An 89-year-old woman presented with a six-day history of reduced vision and distortion in the left eye. Best-corrected visual acuity in that eye was 6/15. Fundoscopy revealed a giant PED and exudates temporally to the fovea. Optical coherence tomography showed a PED associated with subretinal and intraretinal fluid. Fluorescein angiography confirmed the diagnosis of an occult choroidal neovascularization. Treatment with intravitreal injections of ranibizumab (Lucentis) was recommended, although the increased risk of retinal pigment epithelium (RPE) rip was mentioned.
Four weeks after the first intravitreal Lucentis injection, the visual acuity in the left eye improved to 6/7.5, with a significant improvement of the distortion and a complete anatomical resolution of the PED confirmed by optical coherence tomography.
Giant PED secondary to exudative ARMD can be successfully treated with intravitreal ranibizumab, despite the increased risk of RPE rip. To our knowledge, this is the first case presenting with complete resolution of PED after a single ranibizumab injection.
描述一名患有渗出性年龄相关性黄斑变性(ARMD)继发巨大色素上皮脱离(PED)的患者,经单次玻璃体内注射雷珠单抗(Lucentis,0.5mg/0.05ml)成功治疗。
一名89岁女性,左眼视力下降和视物变形6天。该眼最佳矫正视力为6/15。眼底镜检查显示在黄斑中心凹颞侧有一个巨大的PED和渗出物。光学相干断层扫描显示PED伴有视网膜下和视网膜内液。荧光素血管造影确诊为隐匿性脉络膜新生血管。尽管提到了视网膜色素上皮(RPE)撕裂风险增加,但仍建议进行玻璃体内注射雷珠单抗(Lucentis)治疗。
首次玻璃体内注射Lucentis四周后,左眼视力提高到6/7.5,视物变形明显改善,光学相干断层扫描证实PED完全解剖复位。
尽管RPE撕裂风险增加,但渗出性ARMD继发的巨大PED可通过玻璃体内注射雷珠单抗成功治疗。据我们所知,这是首例单次注射雷珠单抗后PED完全消退的病例。