Lorusso Massimo, Micelli Ferrari Luisa, Nikolopoulou Eleni, Micelli Ferrari Tommaso
Department of Ophthalmology, Ente Ecclesiastico "F. Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy.
Department of Ophthalmology, "G. Moscati" Hospital, Taranto, Italy.
Case Rep Ophthalmol Med. 2019 Jan 6;2019:5241573. doi: 10.1155/2019/5241573. eCollection 2019.
To describe a case of a 25-year-old man with choroidal neovascularization (CNV) secondary to traumatic choroidal rupture treated with intravitreal bevacizumab and to evaluate the vascular structure of the area near the traumatic choroidal rupture.
The patient underwent complete ophthalmologic evaluation, including best-corrected visual acuity (BCVA), intraocular pressure, anterior segment and funds examination, and optical coherence tomography angiography (OCTA) at baseline and on each follow-up visit. Fluorescein angiography (FA) was performed at baseline. Intravitreal bevacizumab was administered at the time of choroidal neovascular membrane diagnosis.
At baseline, ophthalmoscopic examination of the left eye revealed four subretinal macular hemorrhages and two choroidal ruptures located temporally to the fovea. On OCT angiograms, the choroidal rupture appeared as a hypointense break in choriocapillaris plexus. At 4-week follow-up, the OCTA disclosed a well circumscribed lesion characterized by numerous and fine anastomotic vessels. Patient received intravitreal injection of bevacizumab. At 6-week post injection, OCTA documented regression of the neovascular complex.
Choroidal neovascularization is a common complication associated with traumatic choroidal rupture and OCTA may represent a complementary diagnostic technique to evaluate the vascular structure of the area near the traumatic choroidal rupture.
描述一例25岁男性因外伤性脉络膜破裂继发脉络膜新生血管化(CNV)并接受玻璃体内注射贝伐单抗治疗的病例,并评估外伤性脉络膜破裂附近区域的血管结构。
患者在基线及每次随访时均接受了全面的眼科评估,包括最佳矫正视力(BCVA)、眼压、眼前段和眼底检查以及光学相干断层扫描血管造影(OCTA)。在基线时进行了荧光素血管造影(FA)。在诊断脉络膜新生血管膜时给予玻璃体内注射贝伐单抗。
基线时,左眼眼底检查发现四个黄斑下视网膜出血和两个位于黄斑颞侧的脉络膜破裂。在OCT血管造影上,脉络膜破裂表现为脉络膜毛细血管丛中的低信号中断。在4周随访时,OCTA显示一个边界清晰的病变,其特征为大量细小的吻合血管。患者接受了玻璃体内注射贝伐单抗。注射后6周,OCTA记录到新生血管复合体消退。
脉络膜新生血管化是外伤性脉络膜破裂的常见并发症,OCTA可能是评估外伤性脉络膜破裂附近区域血管结构的一种补充诊断技术。