Kreissig Ingrid, Mennel Stefan
Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, Mannheim, Germany.
Department of Ophthalmology, Phillips-University Marburg, Marburg, Germany.
Int Med Case Rep J. 2025 Sep 15;18:1211-1214. doi: 10.2147/IMCRJ.S548958. eCollection 2025.
Iris neovascularization and vitreous hemorrhages are typical sequels of ischemic retinopathies. Here, we report about a patient who developed marked iris neovascularization without signs of posterior retinal ischemia.
A 56-year-old patient developed marked iris neovascularization after surgery for rhegmatogenous retinal detachment due to a giant retinal tear had been performed 40 years earlier. With repeatedly applied intravitreal injections of an anti-VEGF drug being unsuccessful, anterior retinal cryocoagulations with deep indentation by the cryoprobe to somehow touch and coagulate the detached anterior flap of giant tear were carried out. Subsequently, the vitreous hemorrhage cleared without any further intervention, and iris neovascularization subsided. Retinal fluorescein angiogram did not reveal signs of ischemia of the attached central retina.
Marked iris neovascularization can disappear after applying peripheral retinal cryocoagulation and laser coagulation. It may lead to the question whether neovascular AMD, potentially associated with macular ischemia, might theoretically be addressable by ablative procedures of the peripheral retina.
虹膜新生血管形成和玻璃体积血是缺血性视网膜病变的典型后遗症。在此，我们报告一例出现明显虹膜新生血管形成但无视网膜后部缺血迹象的患者。
一名56岁患者在40年前因巨大视网膜裂孔行孔源性视网膜脱离手术后出现明显虹膜新生血管形成。反复玻璃体内注射抗VEGF药物无效，遂行前部视网膜冷冻凝固术，用冷冻探头进行深度压陷以接触并凝固巨大裂孔分离的前部瓣片。随后，玻璃体积血自行清除，无需进一步干预，虹膜新生血管也消退。视网膜荧光血管造影未显示附着的中央视网膜有缺血迹象。
应用周边视网膜冷冻凝固术和激光凝固术后，明显的虹膜新生血管可能消失。这可能引发一个问题，即理论上与黄斑缺血潜在相关的新生血管性年龄相关性黄斑变性是否可通过周边视网膜消融手术来治疗。
