Vitreous Retina Macula Consultants of New York, New York, New York.
Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York; and.
Retin Cases Brief Rep. 2024 Sep 1;18(5):593-597. doi: 10.1097/ICB.0000000000001459.
The purpose of this study was to report the multimodal imaging features of a cavitary choroidal nevus showing thickness fluctuations that mirrored the response of diabetic macular edema (DME) to intravitreal antivascular endothelial growth factor (VEGF) therapy.
This is a retrospective case report. Multimodal imaging findings including fundus photography, optical coherence tomography (OCT), fluorescein and indocyanine green angiography, OCT-angiography (OCTA), and B-scan ultrasonography were analyzed.
A woman in her 80s with a cavitary choroidal nevus and DME was treated with intravitreal anti-VEGF therapy using a pro re nata regimen over 5 years. The choroidal nevus showed thickness fluctuations paralleling the response of DME to anti-VEGF therapy. Worsening of the DME was associated with marked increased choroidal lesion thickness on OCT. Conversely, resolution of DME after intravitreal anti-VEGF injections was followed by choroidal lesion flattening on OCT. Variations of the choroidal lesion thickness were mainly dependent on changes of intralesional hyporeflective caverns on OCT.
Our report shows thickness variations of a cavitary choroidal nevus that paralleled the clinical course of DME treated with intravitreal anti-VEGF therapy. To the best of our knowledge, this is the first report on volume variations of a cavitary choroidal nevus after anti-VEGF therapy.
本研究旨在报告一例空洞性脉络膜黑色素瘤的多模态影像学特征，其厚度变化与糖尿病性黄斑水肿（DME）对玻璃体内抗血管内皮生长因子（VEGF）治疗的反应相吻合。
这是一项回顾性病例报告。分析了包括眼底照相、光学相干断层扫描（OCT）、荧光素和吲哚青绿血管造影、OCT 血管造影（OCTA）和 B 型超声扫描在内的多模态成像结果。
一名 80 多岁的女性患有空洞性脉络膜黑色素瘤和 DME，采用按需治疗方案接受了 5 年的玻璃体内抗 VEGF 治疗。脉络膜黑色素瘤的厚度随 DME 对抗 VEGF 治疗的反应而波动。DME 恶化与 OCT 上脉络膜病变厚度的明显增加相关。相反，玻璃体内抗 VEGF 注射后 DME 的缓解后，OCT 上的脉络膜病变变平。脉络膜病变厚度的变化主要取决于 OCT 上病变内低反射性空洞的变化。
我们的报告显示，空洞性脉络膜黑色素瘤的厚度变化与玻璃体内抗 VEGF 治疗 DME 的临床病程相吻合。据我们所知，这是第一份关于抗 VEGF 治疗后空洞性脉络膜黑色素瘤体积变化的报告。
