Miriam Garcia Fernandez_SCIENTIFIC POSTER 2015_2

Advantages:

To report a case of a patient with a history of central serous chorioretinopathy who developed choroidal neovascularization after photodynamic therapy.

Methods:

A 54-year-old female presented with progressive diminution of visual acuity in her right eye (RE). A complete ocular examination, including determination of Visual Acuity (VA), anterior and posterior biomicroscopy, optical coherence tomography (OCT), and fluorescein angiography (FA), was performed.

Effectiveness / Safety:

At first visit, VA was 0.5 (decimal notation) in her RE and 1.0 in her left eye (LE). Anterior segment examination showed no alterations. Funduscopy, FA and OCT confirmed the diagnosis of central serous chorioretinopathy. We decided a conservative management, based on observation, but three months later VA in RE diminished to 0.4, and photodynamic therapy was performed. One month after this treatment, VA in RE increased to 0.6, but three months later the patient complained of deterioration of vision, with a VA of 0.3 in her RE. Funduscopy, fluorescein angiography and OCT confirmed the presence of a subretinal neovascular membrane in RE. Based on these findings, three monthly intravitreal bevacizumab injections were administrated, with good functional and anatomic outcomes. Visual acuity one month after last injection was 0.7 in RE. At last examination (one year after last intravitreal injection) VA was 0.3, and funduscopy and OCT exploration showed macular atrophy without signs of activity. Photodynamic therapy, which entails the intravenous administration of verteporfin (Visudyne; Novartis AG, Basel, Switzerland), has been used successfully to treat choroidal neovascularization secondary to high myopia, age-related macular degeneration, and ocular histoplasmosis syndrome. Moreover, it could be an effective and durable option for treating patients with persistent central serous chorioretinopathy. Despite these advantages, adverse events can also happen, such as occurred in our patient, who developed choroidal neovascularization four months after application of photodynamic therapy. This association had not yet been described in peer-reviewed literature. We consider it is important not to perform too extensive photodynamic therapy treatments, because of the risk of subretinal neovascular development over the scarring tissue.

Contact Details:

Email: migarci@hotmail.es
Cell Phone: +34629853800