Terelak-Borys Barbara, Zagajewska Katarzyna, Jankowska-Lech Irmina, Tesla Piotr, Grabska-Liberek Iwona
Department of Ophthalmology, Centre of Postgraduate Medical Education, Prof W Orlowski Clinical Hospital, Warsaw, Poland.
Ther Clin Risk Manag. 2016 Sep 23;12:1467-1471. doi: 10.2147/TCRM.S110556. eCollection 2016.
The purpose of this study was to describe a combination treatment for choroidal neovascular (CNV) membrane, secondary to punctate inner choroidopathy (PIC).
A 44-year-old female patient was diagnosed with PIC complicated by the development of recurrent juxtafoveal neovascular membrane. The treatment included a sequence of monotherapy regimens: systemic steroid therapy, photodynamic therapy, and intravitreal injections of vascular endothelial growth factor (VEGF) inhibitor (anti-VEGF). Owing to the CNV membrane resistance to various types of monotherapy, a combination treatment consisting of local injections of steroid underneath the Tenon's capsule and intravitreal anti-VEGF injections was used.
Systemic steroid therapy resulted in rapid local improvement with a very short remission period. No positive effects of photodynamic therapy were observed. Sequential anti-VEGF injections led to remission periods of several months. Permanent regression of CNV membrane was achieved following combined local application of steroid and intravitreal anti-VEGF injections.
A combination treatment including steroid and anti-VEGF medication characterized by anti-inflammatory and antiangiogenic effects may be a very beneficial option for the treatment of recurrent CNV membrane as a complication of PIC.
本研究的目的是描述一种针对继发于点状内层脉络膜病变（PIC）的脉络膜新生血管（CNV）膜的联合治疗方法。
一名44岁女性患者被诊断为PIC并发复发性黄斑旁新生血管膜。治疗包括一系列单一疗法：全身类固醇治疗、光动力疗法以及玻璃体内注射血管内皮生长因子（VEGF）抑制剂（抗VEGF）。由于CNV膜对各种类型的单一疗法均有抵抗，因此采用了由在Tenon囊下局部注射类固醇和玻璃体内抗VEGF注射组成的联合治疗方法。
全身类固醇治疗导致局部迅速改善，但缓解期非常短。未观察到光动力疗法的积极效果。序贯抗VEGF注射导致数月的缓解期。在联合局部应用类固醇和玻璃体内抗VEGF注射后，CNV膜实现了永久性消退。
包括具有抗炎和抗血管生成作用的类固醇和抗VEGF药物的联合治疗可能是治疗作为PIC并发症的复发性CNV膜的非常有益的选择。
