Bilgic Alper, Sudhalkar Aditya
Alphavision Augenzentrum, Bremerhaven, Germany.
Ophthalmology, Eye Hospital and Retinal Laser Centre, Baroda, India.
BMJ Case Rep. 2019 Sep 6;12(9):e231262. doi: 10.1136/bcr-2019-231262.
A 67-year-old man was diagnosed to have dry age related macular degeneration in the right eye and a choroidalneovascular membrane (CNVM) with a large pigment epithelial detachment in the left eye, confirmed with clinical examination, angiography and optical coherence tomography scans. He received an intravitreal injection of bevacizumab in the right eye and developed a retinal pigment epithelial (RPE) tear 3 weeks later. 3 consecutive ranibizumab injections failed to clear the subretinal fluid (SRF). A course of systemic steroids was administered and this improved the vision. Subsequently, the patient received one more ranibizumab injection and the disease process resolved. The left eye corrected distance visual acuity (LE CDVA) was 20/30 at the final visit (1 year after the last injection). Systemic steroids may be a management option in patients with CNVM and RPE tear with recalcitrant SRF if there is no contraindication to their use.
一名67岁男性被诊断为右眼干性年龄相关性黄斑变性，左眼有脉络膜新生血管膜（CNVM）并伴有大片色素上皮脱离，经临床检查、血管造影和光学相干断层扫描证实。他右眼接受了玻璃体腔内注射贝伐单抗，3周后出现视网膜色素上皮（RPE）撕裂。连续3次注射雷珠单抗未能清除视网膜下液（SRF）。给予一个疗程的全身类固醇治疗后视力得到改善。随后，患者又接受了一次雷珠单抗注射，疾病进程得到缓解。最后一次就诊时（最后一次注射后1年），左眼矫正远视力（LE CDVA）为20/30。如果没有使用全身类固醇的禁忌证，对于患有CNVM和RPE撕裂且视网膜下液顽固不吸收的患者，全身类固醇可能是一种治疗选择。
