Nakano Yumiko, Miki Akiko, Honda Shigeru, Nakamura Makoto
Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan.
Case Rep Ophthalmol. 2018 Jan 29;9(1):92-95. doi: 10.1159/000485966. eCollection 2018 Jan-Apr.
To report a case of polypoidal choroidal vasculopathy associated with optic disc coloboma.
Case report.
A 50-year-old woman presented with optic disc coloboma and retinochoroidal coloboma associated with subretinal hemorrhage and serous retinal detachment (SRD) in her left eye. Optical coherence tomography (OCT) confirmed SRD at the macula and showed a sharply elevated retinal epithelial detachment at the choroidal excavation. OCT also revealed choroidal cavitation along the temporal side of the optic coloboma. Fluorescein angiography showed hyperfluorescent dye leakage and indocyanine green angiography revealed polypoidal lesions. We diagnosed polypoidal choroidal vasculopathy (PCV). PCV was located at the end of the choroidal cavitation. Her left eye was treated with an intraocular injection of the anti-vascular endothelial growth factor aflibercept (2 mg). Photodynamic therapy was performed using the standard protocol 1 week after the intravitreal application of aflibercept. One month after the combined treatment, OCT showed completely resolved SRD and her symptoms disappeared. Her best-corrected visual acuity remained stable and no recurrence was found during a 12-month follow-up period.
PCV associated with optic disc coloboma has not been previously reported. The morphological abnormality of choroidal cavitation and choroidal excavation connecting with optic disc coloboma may contribute to the development of PCV in this case.
报告一例与视盘缺损相关的息肉样脉络膜血管病变。
病例报告。
一名50岁女性左眼出现视盘缺损及视网膜脉络膜缺损，并伴有视网膜下出血和浆液性视网膜脱离（SRD）。光学相干断层扫描（OCT）证实黄斑区存在SRD，并显示脉络膜凹陷处视网膜上皮脱离明显抬高。OCT还显示视盘缺损颞侧有脉络膜空洞形成。荧光素血管造影显示荧光素渗漏，吲哚菁绿血管造影显示息肉样病变。我们诊断为息肉样脉络膜血管病变（PCV）。PCV位于脉络膜空洞的末端。左眼接受了抗血管内皮生长因子阿柏西普（2mg）玻璃体内注射治疗。在玻璃体内注射阿柏西普1周后，按照标准方案进行了光动力疗法。联合治疗1个月后，OCT显示SRD完全消退，症状消失。最佳矫正视力保持稳定，在12个月的随访期内未发现复发。
此前尚未有视盘缺损相关的PCV报道。脉络膜空洞及与视盘缺损相连的脉络膜凹陷的形态学异常可能是该病例中PCV发生的原因。
