Smt. Kanuri Santhamma Centre for Vitreo-Retinal Diseases, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Indian J Ophthalmol. 2018 Mar;66(3):463-466. doi: 10.4103/ijo.IJO_837_17.
A 64-year-old male patient presented to the clinic with diminished vision in his right eye for the past 2 years. Examination revealed a best-corrected visual acuity (BCVA) of counting fingers at 1 m with a scarred choroidal neovascular membrane (CNVM) in the right eye while the left eye had a BCVA of 20/20 with a small peripapillary subretinal hemorrhage along with angioid streaks in both eyes. Multimodal imaging revealed the presence of a CNVM in the left eye which was treated with focal thermal laser. Regression was noted on optical coherence tomography angiography at 1 month post-laser, but at 3-month follow-up, exacerbation of the CNVM was observed. Subsequently, four intravitreal ziv-aflibercept injections were given, and scarring of CNVM was noted on OCT. Thermal laser in the background of angioid streaks has worsened the breaks in the Bruch's membrane leading to worsening of the CNVM.
一位 64 岁男性患者因右眼视力下降 2 年来就诊。检查发现右眼最佳矫正视力（BCVA）为眼前指数，右眼有脉络膜新生血管膜（CNVM）瘢痕，左眼 BCVA 为 20/20，双眼均有视盘旁小视网膜下出血和格子样变性。多模态成像显示左眼存在 CNVM，行局部热激光治疗。激光治疗后 1 个月 OCT 血管造影显示 CNVM 消退，但 3 个月随访时观察到 CNVM 加重。随后给予 4 次玻璃体内注射 ziv-aflibercept，OCT 显示 CNVM 瘢痕形成。格子样变性背景下的热激光加重了布鲁赫膜的破裂，导致 CNVM 恶化。
