Veronica Ramos Camara_SCIENTIFIC POSTER 2015

An 8-years-old boy was referred to our service for evaluation of decreasing vision in his right eye.

Personal Background:

Patent ductus arteriosus surgery. His family denied history of trauma or inflammation. His best corrected visual acuity in his right eye was light perception and 20/20 in his left eye. Retinography showed subfoveal choroidal neovascular membrane (CNVM) with subretinal hemorrhage. Fluorescein angiography showed an early hyperfluorescent area with diffuse leakage on the late phase, corresponding to the CNVM. OCT showed intrarretinal fluid and subretinal fibrosis area paramacular superior. The diagnosis was idiopathic choroidal neovascular membrane and we decided to treat the membrane with three intravitreal Ranibizumab injections. At the third-month follow-up visit, after the intravitreal inyections, visual acuity improved to 20/100 in his right eye. Angiography showed contraction of the membrane, and OCT showed contraction of the membrane, and OCT showed marked reduction in the intraretinal fluids. No adverse ocular or systemic side effects are observed with intravitreal ranibizumab inyections in our case. The patient remains under close follow-up.

Discussion:

The response to treatment was great in our case, and the hypothesis might be the response to treatment in idiophatic choroidal neovascular membrane in children could be better than reported for eyes with CNVM associated with AMD because there is a higher vascular componet in children membranes. We can not conclude based in our case, so further studies are needed.

Figure 1. Retinography shows subfoveal choroidal neovascular membrane (CNVM) with subretinal hemorrhage on initial examination and after treatment shows disappearance of subretinal blood and size membrane reduction. Angiography on inictial examination shows an hyperfluorescence area corresponding to the CNVM, and the contraction of the membrane after treatment.

Figure 2. OCT shows intraretinal fluid in foveal area and after treatment OCT shows marked reduction in the intraretinal fluids and better foveal morphology.

Figure 3. OCT shows fibrosis in superior macular area with fluids and after treatment OCT shows the fibrosis without fluids in the same area.

Figure 4. Autofluorescence shows hyperautofluorescence central area surrounded by ring of hypoautofluorescence, and after treatment shows less hyperautofluorescence central area surrounded by larger ring of hypoautofluorescence.

Contact Details:

Email: veronicaramos85@gmail.com
Cell Phone: +34660304485

Veronica Ramos