Department of Ophthalmology, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, South Korea.
Retin Cases Brief Rep. 2023 May 1;17(3):324-328. doi: 10.1097/ICB.0000000000001181. Epub 2021 Jul 16.
To report a case of exudative perifoveal vascular anomalous complex treated with a 532-nm subthreshold micropulse laser unresponsive to intravitreal injections.
A case report.
A 65-year-old woman presented with blurred vision in the left eye for 1 month. An isolated perifoveal aneurysm surrounded by retinal hemorrhages and hard exudates was revealed in fundus examination, and optical coherent tomography showed a round lesion with a hyperreflective wall, subretinal fluid, and an intraretinal cyst. She was diagnosed with exudative perifoveal vascular anomalous complex and received four intravitreal injections. However, her best-corrected visual acuity decreased, and an aneurysmal lesion with macular edema persisted for approximately 6 months. Three sessions of 532-nm subthreshold micropulse laser therapy around the aneurysm were applied because the intravitreal injection treatment was ineffective. Since the last session, macular edema disappeared, the involuted lesion remained substantially stable without recurrence, and her best-corrected visual acuity improved without visual field defect.
To our knowledge, this is the first report of a successful subthreshold micropulse laser treatment for an exudative perifoveal vascular anomalous complex lesion, and it could be a safe and effective method for the patient unresponsive to intravitreal injections.
报告一例对玻璃体腔内注射治疗无反应的渗出性中心性小凹血管异常复合病变采用 532nm 亚阈微脉冲激光治疗的病例。
病例报告。
一名 65 岁女性左眼视力模糊 1 个月。眼底检查发现孤立性中心小凹旁动脉瘤,周围有视网膜出血和硬性渗出,光学相干断层扫描显示圆形病变,伴有高反射壁、视网膜下液和视网膜内囊。诊断为渗出性中心性小凹血管异常复合病变,并接受了 4 次玻璃体腔内注射治疗。然而,她的最佳矫正视力下降,黄斑水肿的动脉瘤性病变持续了大约 6 个月。由于玻璃体腔内注射治疗无效,对动脉瘤周围进行了 3 次 532nm 亚阈微脉冲激光治疗。自最后一次治疗以来,黄斑水肿消失,退行性病变基本稳定,无复发,最佳矫正视力提高,无视野缺损。
据我们所知,这是首例成功应用亚阈微脉冲激光治疗渗出性中心性小凹血管异常复合病变的报道,对于对玻璃体腔内注射治疗无反应的患者,这可能是一种安全有效的方法。