A Case of Combination Therapy for Subretinal Neovascularization in Bilateral Acquired Parafoveal Telangiectasis

Jeong-Wan Ryu; Jae-Ryun Kim; Won-Ki Lee

doi:10.3341/jkos.2009.50.9.1423

Journal List > J Korean Ophthalmol Soc > v.50(9) > 1008374

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Ryu, Kim, and Lee: A Case of Combination Therapy for Subretinal Neovascularization in Bilateral Acquired Parafoveal Telangiectasis

Original Article

J Korean Ophthalmol Soc 2009;50(9):1423-1426.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.9.1423

A Case of Combination Therapy for Subretinal Neovascularization in Bilateral Acquired Parafoveal Telangiectasis

Jeong-Wan Ryu, MD, Jae-Ryun Kim, MD, Won-Ki Lee, MD

Department of Ophthalmology and Visual Science, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Won Ki Lee, MD Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University #505 Banpo-dong, Seocho-gu, Seoul 137-701, Korea Tel: 82-2-2258-2846, Fax: 82-2-599-7405, E-mail: wklee@catholic.ac.kr

Received 20 March 2009 Accepted 2 June 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical results of a case of subretinal neovascularization (SRN) in bilateral acquired parafoveal telangiectasis, performed combination therapy of intravitreal bevacizumab (1.25 mg/0.05ml) and photodynamic therapy (PDT).

Case summary

A 46-year-old female presented with a decrease invisual acuity. Her best-corrected visual acuity (BCVA) was 1.0 in the right eye and 0.1 in the left eye. On ophthalmic examination, she was diagnosed with bilateral acquired parafoveal telangiectasis combined with SRN in the left eye. Intravitreal bevacizumab was injected, and then photodynamic therapy was performed 4 days later. Three months after the combination therapy, her BCVA improved to 0.5, a regression of SRN was observed and vascular leakage was markedly decreased. However, her BCVA decreased to 0.1 and SRN recurred 9 months later.

Conclusions

The combined treatment of intravitreal bevacizumab and photodynamic therapy may be used as a selective alternative treatment modality for SRN in bilateral acquired parafoveal telangiectasis, although its effect is short-term.

Keywords: Bevacizumab, Bilateral acquired parafoveal telangiectasis, Combination therapy, Photodynamic therapy, Subretinal neovascularization

References

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Figure 1.

(A-C) Fundus photograph shows telangiectatic vessels surrounded by grayish discoloration (A). Fluorescein angiography (FA) shows late leakage from the telangiectatic vessel (B, C).

Figure 2.

(A-C) At baseline, fundus photograph shows superficial retinal hemorrhage surrounded by grayish discoloration and abnormal vasculature (A). Fluorescein angiography (FA) shows subretinal neovascularization (SRN) connected with telangiectatic vessels in the early phase (B) with intense leakage in the late phase (C). (D-F) At 3 months after single combination therapy, the superficial retinal hemorrhage disappeared (D). FA shows marked decrease of leakage due to regression of SRN and decreased telangiectatic vessels (E, F). G∼I At 9 months, fundus findings and FA show recurrence of SRN having intense leakage in the late phase (G, H, I).

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