The Use of Anti-VEGF Preparations and PDT in the Treatment of Retinal Juxtapapillary Hemangioma - A Case Report
Authors:
V. Matušková; D. Vysloužilová
Authors place of work:
Oční klinika FN a LF MU, Brno
přednostka prof. MUDr. Eva Vlková, CSc.
Published in the journal:
Čes. a slov. Oftal., 70, 2014, No. 5, p. 196-200
Category:
Case Report
Summary
Aim:
The aim of this paper is to present clinical experience with the therapy of retinal juxtapapillary hemangioma using the intravitreal application of anti-VEGF substance (bevacizumab) and photodynamic therapy (PDT) with verteporfine (Visudyne).
Material and methods:
The authors present a case of a 34 years old male patient with diagnosed retinal hemangioma localized on the optic disc. Subjectively, the patient noticed decrease of vision, and during the clinical examination, the edema in the macula region spreading from the hemangioma with hard exsudates was found; the best-corrected visual acuity (BCVA) was 4/20 (0.2).
Results:
First, the patient was treated by intravitreal applications of bevacizumab; after the first application, the edema from the macula subsided, and the best-corrected visual acuity improved to 4/12 (0.33). After one month of the first application, a recurrence of the edema occurred and other two injections of bevacizumab were applied; despite this treatment, further worsening of the exsudation from the hemangioma and worsening of the BCVA to 4/32 (0.125) occurred. Subsequently, one session of photodynamic therapy with verteporfine was held. After this therapy, the finding on the posterior ocular pole was stabilized; the BCVA was 4/40 (0.1). Even one year after the PDT therapy, no recurrence was present.
Conclusion:
According to our experience, the PDT with Visudyne appears as promising therapy method of juxtapapillary capillary hemangiomas. The PDT decreases the leaking of the fluid from hemangioma and decreases the size of hemangioma.
Key words:
Capillary hemangioma, PDT, juxtapapillary hemangioma, bevazicumab, verteporfine, von Hippel – Lindau disease
Zdroje
1. Bari, S.J., Sears, J.E., Singh, A.D.: Transient closure of a retina capillary hemangioma with verteporfin photodynamic therapy, Retina, 25, 2005, 8: 1103–1104.
2. Dahr, S.S., Cusick, M., Roudriguez-Coleman, H. et al.: Intravitreal anti-vascular endothelial growth factor therapy with pegaptanib for advanced von Hippel-Lindau disease of the retina, Retina, 27, 2007; 2: 150–158.
3. Kanski, J.J.: Clinical Ophthalmology, A Systemic Aproach, 6th Edition, Butterworth Heinemann Elsevier, 2007, 930 str.
4. Karel, I., Kadlecová, J., Otradovec, J.: Fotokoagulace Hippelovy angiomatózy sítnice ve fluoroangiografickém obraze. Čs Oftalmol, 29,1973; 5: 358–362.
5. Mc Gabe, M.M., Flynn, H.W., Shields, C.L. et al.: Juxtapapillary capillary hemangiomas. Clinical features and visual acuity outcomes. Ophthalmology, 2000;107: 2240–8.
6. Mennel, S., Meyer, C.H., Callizo, J. et al.: Combined intravitreal anti-vascular endothelial growth factor (Avastin) and photodynamic therapy to treat retinal juxtapapillary capillary haemangioma. Acta Ophthalmol, 88, 2010; 5: 610–613.
7. Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials—TAP report. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Arch Ophthalmol, 117, 1999, 10: 1329–45.
8. Schmidt-Erfurth, U., Hasan, T., Gragouda., E. et al.: Vascular targeting in photodynamic occlusion of subretina vessels. Ophthalmology, 101; 1994: 1953–61.
9. Schmidt-Erfurth, U.M., Kusserow, C., Barbazetto, I.A. et al: Benefits and complications of photodynamic therapy of papillary capillary hemangiomas. Ophthalmology, 109, 2002; 7: 1256–66.
10. Singh, A.D., Shields, C.L., Shields, J.A.: Von Hippel Lindau disease. Surv Ophthalmol, 46, 2001; 2: 117–142.
11. Von Buelow, M., Pape, s. et Hoerauf, H.: Systemic bevacizumab treatment of a juxtapapillary retinal haemangioma, Acta Ophth Scandinavica, 2007; 85: 114–116.
12. Wackernagel, W., Lackner, E., Pilz, S. et al.: Von Hippel–Lindau disease: treatment of retinal haemangioblastomas by targeted therapy with systemic bevacizumab. Acta Ophthalmol, 2010; 88: 271–272.
13. Ziemssen et al.: Combined treatment of a juxtapapillary retinal capillary haemangioma with intravitreal bevacizumab and photodynamic therapy. Eye, 2007; 21: 1125-1126.
Štítky
Maxillofacial surgery OphthalmologyČlánok vyšiel v časopise
Czech and Slovak Ophthalmology
2014 Číslo 5
Najčítanejšie v tomto čísle
- Oculars Disturbances as First Sign of Decompensated Arterial Hypertension
- Retinal Tamponade with Silicone Oil – Long Term Results
- The Glaucoma Pharmacological Treatment and Biomechanical Properties of the Cornea
- The Incidence of Endophtalmitis after the Application of Intravitreal Injections in FNKV with Regard to Various Prophylactic Antibiotic Regimens