Anti-VEGF treatment of diabetic 1. type: case report

Česká verzia

Authors: Lívia Javorská; Mária Michalková; Alena Kučerová
Authors place of work: Očné oddelenie JZS, Nemocnica Poprad a. s., primárka MUDr. Mária Michalková
Published in the journal: Forum Diab 2013; 2(3): 185-188
Category: Main Theme: Case Report

Summary

Objective:
To describe the clinical course of treatment with ranibizumab in young diabetic patient metabolically decompensated with diabetic macular edema (DME) and extensive neovascularization of the disc (NVD).

Case report:
23 years old diabetic patient suffering from type 1 diabetes was sent to our department for retinal laser treatment. 10 years has been treated as type 1 diabetic patient, but was still poorly metabolically compensated. The patient was sent from catchment area in March 2012. From March 2012 to June 2012 was treated with intensive panretinal photocoagulation (PRP) in both eyes. In July 2012 we observed significant NVD development, especially on the left. We decided to initiate therapy with anti-VEGF in left eye. Inspite of the 10.3 % glycated hemoglobin (HbA_1c) at that time, requested therapy was approved by health insurance, especially because of the young age of the patient. Later ranibizumab was administered to the right eye. The patient had prior to initiation of therapy with anti-VEGF the best corrected visual acuity (BCVA) on the right 20/80, 54 letters, on the left 20/100, 52 letters. After the first three doses of ranibizumab to the left eye BCVA increased to 20/32, 76 letters. On the right after three doses of ranibizumab BCVA increased to 20/32, 73 letters. We observed significant regression of NVD and DEM in both eyes. We applied ranibizumab to the patient right eye 5 times and to the left eye 6 times until september 2013. Throughout course of therapy was HbA_1c more than 8.5 %, reflecting poor metabolic control. In september 2013 the right BCVA was 20/40, 68 letters and left BCVA 20/40, 70 points.

Key words:
anti-VEGF – diabetes mellitus type 1 – diabetic macular edema – optic disc neovascularization – ranibizumab

Zdroje

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