scholarly journals Effects of intravitreal aflibercept (Eylea) in the treatment of bilateral cystoid macular edema in retinitis pigmentosa: A case report

2019 ◽  
Vol 72 (5-6) ◽  
pp. 171-175
Author(s):  
Sofija Davidovic ◽  
Sanja Jovanovic ◽  
Nikola Babic ◽  
Aleksandar Miljkovic ◽  
Desanka Grkovic ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Intravitreal Therapy ◽  
Short Period ◽  
Patient Reported ◽  
Intravitreal Aflibercept ◽  
Repeated Doses ◽  
The Right

Introduction. The aim of the study was to evaluate the effects of intravireal injections of aflibercept (Eylea) on bilateral cystoid macular edema in a patient with retinitis pigmentosa. Material and Methods. A 17-year-old man presented with a moderate bilateral decrease of visual acuity (0.3) and ocular examination was performed. Optical coherence tomography imaging was performed and cystoid macular edema was detected in both eyes. Due to disease progression in a short period of time, intravitreal repeated injections of aflibercept (Eylea) were initiated according to recent clinical reports. Results. The initial values of cystoid macular edema before intravitreal therapy were 248 ?m in the right and 237 ?m in the left eye; they increased slowly in next several weeks. Four bilateral repeated doses of intravitreal aflibercept injections at 6-week intervals were given in local anesthesia. The patient reported a subjective improvement, and his visual acuity was 4/10 in both eyes. Objectively, the macular edema decreased at week 24, reaching 173 ?m in the right and 188 ?m in the left eye. Conclusion. There are few literature reports on the possible effects of intravitreal aflibercept injections in the treatment of retinitis pigmentosa-related cystoid macular edema. In our study, bilateral macular edema in a patient with retinitis pigmentosa has improved significantly after four consecutive treatments. Further studies are necessary with a larger sample size and longer follow-up period to obtain information on the role and safety of intravitreal drugs for cystoid macular edema in retinitis pigmentosa. <br><br><font color="red"><b> This article has been corrected. Link to the correction <u><a href="http://dx.doi.org/10.2298/MPNS1910326E">10.2298/MPNS1910326E</a><u></b></font>

scholarly journals Intravitreal and Subtenon Depot Triamcinolone as Treatment of Retinitis Pigmentosa Associated Cystoid Macular Edema

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Sidnei Barge ◽  
Renata Rothwell ◽  
Paula Sepúlveda ◽  
Luís Agrelos
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Intravitreal Injection ◽  
Cystoid Macular Edema ◽  
Treatment Options ◽  
Corrected Visual Acuity ◽  
Anatomic Results ◽  
The Right ◽  
Decrease In Visual Acuity

We present a case of retinitis pigmentosa (RP) related cystoid macular edema (CME) refractory to oral acetazolamide and topical ketorolac that was treated with intravitreal and subtenon depot triamcinolone. A 32-year-old male with RP presented with complaints of bilateral decrease in visual acuity. His best-corrected visual acuity (BCVA) was 20/50 in the right eye and 20/100 in the left eye. After being informed of the available treatment options, the patient received bilateral intravitreal injection triamcinolone. The patient’s BCVA improved to 20/40 in the right eye and 20/50 in the left eye and the CME was resorbed. However, 5 months after the injection in the left eye and two months in the right eye, visual acuity decreased due to recurrence of CME. We performed a second intravitreal injection in the left eye with improvement of visual and anatomic results, but we observed a recurrence of CME. Afterwards, we treated the patient with subtenon depot triamcinolone in both eyes, with the result that there was no recurrence after 4 months in OD or after 3 months in OS. We conclude that intravitreal and subtenon depot triamcinolone appear to provide at least temporary benefit in refractory CME as regards the improvement of visual acuity.

scholarly journals Type 3 Neovascularization Associated with Retinitis Pigmentosa

2017 ◽  
Vol 8 (1) ◽  
pp. 245-249 ◽  
Author(s):  
Jihene Sayadi ◽  
Alexandra Miere ◽  
Eric H. Souied ◽  
Salomon Y. Cohen
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Pigment Epithelium ◽  
High Flow ◽  
Type 3 Neovascularization ◽  
Capillary Plexus ◽  
The Right ◽  
Type 3

Purpose: To report a case of type 3 neovascular lesion in a patient with retinitis pigmentosa (RP) complicated by macular edema. Case Report: A 78-year-old man with a long follow-up for RP was referred for painless visual acuity decrease in the right eye. Best-corrected visual acuity was 20/125 in the right eye and 20/40 in the left. Fundus examination showed typical RP and macular edema in both eyes. In the right eye, spectral domain optical coherence tomography revealed a marked cystic macular edema associated with disruption of the Bruch membrane/retinal pigment epithelium complex overlying a pigmentary epithelium detachment, with a vascular structure which appeared to originate from the deep capillary plexus and to be connected with the subretinal pigment epithelium space. Optical coherence tomography angiography showed a high-flow vessel infiltrating the outer retinal layers in the deep capillary plexus segmentation, and a tuft-shaped, bright, high-flow network that seemed to be connected with the subretinal pigment epithelium space in the outer retinal layer segmentation. This presentation was consistent with an early type 3 neovascular lesion in the right eye. Conclusion: Type 3 neovascularization may be considered a possible complication of RP.

scholarly journals Long-term Clinical Outcomes of Cataract Surgery in Patients with Retinitis Pigmentosa

2021 ◽  
Vol 62 (7) ◽  
pp. 931-938
Author(s):  
Ji Hyun Yoon ◽  
Jong Woo Kim ◽  
Chul Gu Kim ◽  
Jae Hui Kim
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Cataract Surgery ◽  
Macular Edema ◽  
Clinical Outcomes ◽  
Cystoid Macular Edema ◽  
Final Visit ◽  
Short Term ◽  
The Mean

Purpose: The long-term clinical outcomes of cataract surgery in patients with retinitis pigmentosa (RP) were evaluated. Methods: A retrospective analysis of medical records was performed for patients who were diagnosed with RP and underwent cataract surgery. Preoperative best-corrected visual acuity (BCVA) was compared with BCVA at 1 month postoperatively and at the final visit. The proportion of patients with cystoid macular edema development or aggravation after surgery was evaluated, as was the proportion of patients with intraocular lens subluxation/dislocation. For patients who underwent optical coherence tomography, factors associated with a BCVA of 0.5 or better at 1 month were analyzed. Results: In total, 133 eyes were included and the mean follow-up period was 58.7 months. The mean logarithm of minimal angle of resolution BCVA was 0.69 ± 0.65 at diagnosis. The BCVA was significantly improved to 0.51 ± 0.47 at 1 month postoperatively (p < 0.001). However, the BCVA at the final visit (0.70 ± 0.81) was similar to the baseline value (p = 1.000). Cystoid macular edema development or aggravation was noted in 8 eyes (6.0%) and intraocular lens subluxation/dislocation was noted in 4 eyes (3.0%). A subgroup analysis involving 108 eyes revealed that preoperative BCVA (p < 0.001) and ellipsoid zone status (p = 0.001) were associated with postoperative visual acuity. Conclusions: Short-term outcomes of cataract surgery in patients with RP were comparatively good. However, long-term visual deterioration was noted with disease progression. Preoperative BCVA and ellipsoid zone status are useful markers for predicting short-term visual outcomes.

scholarly journals Postsurgical Cystoid Macular Edema following Posterior Chamber Toric Phakic Intraocular Lens Implantation Surgery: A Case Report

2015 ◽  
Vol 6 (2) ◽  
pp. 223-227 ◽  
Author(s):  
Julide Canan Umurhan Akkan ◽  
Kemal Tuncer ◽  
Ahmet Elbay
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Macular Edema ◽  
Intraocular Lens ◽  
Cystoid Macular Edema ◽  
Posterior Chamber ◽  
Phakic Intraocular Lens ◽  
Distance Visual Acuity ◽  
Initial Surgery ◽  
The Right

Purpose: To describe a case of cystoid macular edema (CME) developing after posterior chamber toric phakic intraocular lens (PIOL) implantation. Methods: Case report. Results: A 33-year-old male underwent implantation of toric implantable collamer lenses (ICL), a new generation of PIOLs, for both eyes. Preoperative best spectacle-corrected distance visual acuity (BCVA) was 20/25 in the right eye and 20/32 in the left eye, with a manifest refraction of -9.25 -4.0 × 4° and -9.75 -4.25 × 171°, respectively. On day 1 postoperatively, the left eye had an uncorrected distance visual acuity (UDVA) of 20/60 with a refraction of +2.0 -3.5 × 11°. Despite the rotation of the PIOL, the cylindrical refractive component persisted in the left eye with a refraction of +2.0 -3.5 × 11°. Two weeks after the initial surgery, he presented with a decrease in his visual acuity in the left eye. The UDVA and BCVA were both 20/100 in the left eye with a refraction of +2.0 -4.25 × 3°. Dilated fundus examination and macular optical coherence tomography revealed a CME in the left eye. Following topical nepafenac therapy and explantation of the ICL, we observed a complete resolution of the CME at 3 months with an improvement in BCVA to 20/32 in the left eye. Conclusions: To our knowledge, this is the first reported case of postsurgical CME following toric ICL implantation. In cases of phakic eyes with an intact posterior capsule, postsurgical CME can develop, thus highlighting the purpose of this report.

scholarly journals Ocular abnormalities in a large Western China patient cohort with Retinitis Pigmentosa

2020 ◽  
Author(s):  
Lian Tan ◽  
Yanling Long ◽  
Ziyang Li ◽  
Xi Ying ◽  
Jiayun Ren ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Low Vision ◽  
Western China ◽  
Blurred Vision ◽  
Epiretinal Membranes ◽  
Ocular Abnormalities ◽  
Macular Holes

Abstract Background To report the prevalence of ocular abnormalities and investigate visual acuity in a large Western China cohort of retinitis pigmentosa (RP) patients. Methods A retrospective study was performed, reviewing the medical records and ophthalmic examination reports of 2,127 eyes from 1,065 RP patients in one eye hospital. The authors investigated the prevalence of ocular abnormalities and the relationship between best corrected visual acuity (BCVA) and macular abnormalities. Results Nyctalopia (58.2%) and blurred vision (27.1%) were the leading consultation causes. BCVA measurements in the better eyes at first clinical presentation showed that 304 patients (28.5%) were categorised as blind and 220 patients (20.7%) as low vision. The most common ocular abnormalities were cataracts (43.1%) and macular abnormalities (59.7%), including epiretinal membranes (51.1%), cystoid macular edema (18.4%), vitreomacular traction syndrome (2.4%), macular holes (2.3%) and choroidal neovascular membranes (0.05%). Glaucoma was found in 35 eyes (1.6%). The proportions of epiretinal membranes (P=0.001) and macular holes (P=0.008) increased significantly with age. Cystoid macular edema was significantly associated with poorer visual acuity in RP patients with clear lens (P=0.002).Conclusion Cataracts and macular abnormalities are common in RP patients. In the macular abnormalities, cystoid macular edema may have a negative effect on BCVA in RP patients with clear lens. Therefore, OCT screening in RP patients is highly recommended for early detection and treatment of maculopathy.

Effect of Aflibercept on Cystoid Macular Edema Associated with Central Retinal Vein Occlusion. Results from a District Hospital in the United Kingdom

2019 ◽  
Vol 236 (04) ◽  
pp. 547-550
Author(s):  
Georgios Panos ◽  
Vassileios Kostakis ◽  
Grazyna Porter
Keyword(s):  
Visual Acuity ◽  
Adverse Effects ◽  
Macular Edema ◽  
Retinal Vein Occlusion ◽  
Central Retinal Vein Occlusion ◽  
Cystoid Macular Edema ◽  
Vein Occlusion ◽  
Intravitreal Aflibercept ◽  
Central Retinal Vein

Abstract Purpose The purpose of this study was to report the efficiency and safety of intravitreal aflibercept for the treatment of cystoid macular edema (CME) secondary to central retinal vein occlusion (CRVO). Methods This is a retrospective cohort study. Ten naive eyes of ten patients with CME secondary to CRVO were included. All eyes received a loading dose of 3 monthly aflibercept injections followed by as-needed injections at monthly follow-up visits. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were evaluated at baseline and at the end of the follow-up period. Results The median follow-up period was 6 months (range: 6 – 9). The median number of injections was 4 (range: 3 – 5). Median BCVA improved from 1.05 LogMAR units (range: 0.7 – 1.6) at baseline to 0.65 (range: 0.4 – 1.6) at the end of the follow-up period (p = 0.02). Median CRT improved from 690 µm (range: 561 – 1235) at baseline to 243 µm (range: 207 – 531) at the end of the follow-up period (p = 0.002). The power of all statistical tests was greater than 0.8. No adverse effects or complications were documented. Conclusion Intravitreal aflibercept treatment for CME secondary to CRVO significantly improved both macular anatomy and visual acuity without adverse effects.

Aflibercept in the management of acute retinal necrosis syndrome-related macular edema

2017 ◽  
Vol 28 (2) ◽  
pp. 259-261 ◽  
Author(s):  
Leticia Ortega-Evangelio ◽  
Javier Navarrete-Sanchis ◽  
Basil K. Williams ◽  
Juan Miguel Tomás-Torrent
Keyword(s):  
Visual Acuity ◽  
Growth Factor ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Late Complication ◽  
Acute Retinal Necrosis ◽  
Interferon Α ◽  
Varicella Zoster ◽  
First Choice ◽  
Intravitreal Aflibercept

Purpose: Acute retinal necrosis (ARN) is a panuveitis syndrome that may lead to severe complications such as cystoid macular edema (CME). There is no consensus about the best treatment. We report one case of CME secondary to ARN managed with intravitreal aflibercept. Case report: A 41-year-old woman with a history of successfully treated varicella-zoster virus-associated ARN developed an epiretinal membrane (ERM) and underwent pars plana vitrectomy, ERM removal, inner limiting membrane peel, and lensectomy. After surgery, the retinal architecture improved and the visual acuity returned to 20/20. Six months later, she developed nontractional CME, which was treated monthly with triple-dose intravitreal aflibercept (2 mg). She gained 3 lines of vision and CME resolution was achieved. Discussion: Cystoid macular edema is a late complication of ARN that may affect vision. Some off-label therapies have been reported to be useful in CME secondary to ARN, including pegaptanib and interferon-α-2. Since interferon-α-2a is not currently available for ophthalmic use in Spain, aflibercept was the first choice. This soluble protein blocks the placental growth factor and all isoforms of vascular endothelial growth factor (VEGF); its half-life is prolonged and its affinity to VEGF-A is more than 100-fold greater than bevacizumab, pegaptanib, or ranibizumab. After each injection, macular thickness decreased consistently and visual acuity improved 3 lines after the treatment. Conclusions: Intravitreal aflibercept is effective in the management of acute nontractional CME secondary to ARN.

scholarly journals Swept-source optical coherence tomography changes and visual acuity among Palestinian retinitis Pigmentosa patients: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Orjowan Shalabi ◽  
Zaher Nazzal ◽  
Muath Natsheh ◽  
Salam Iriqat ◽  
Michel Michaelides ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Retinitis Pigmentosa ◽  
Macular Edema ◽  
Epiretinal Membrane ◽  
Cystoid Macular Edema ◽  
External Limiting Membrane ◽  
Cross Sectional ◽  
Swept Source ◽  
Ellipsoid Zone ◽  
Hyperreflective Foci

Abstract Background Retinitis pigmentosa (RP) is a heterogeneous group of inherited ocular diseases that result in progressive retinal degeneration. This study aims to describe different Swept-source Optical Coherence Tomographic (SS-OCT) changes in Palestinian RP patients and to explore possible correlations with Visual Acuity (VA). Methods A cross-sectional observational study was conducted on Retinitis Pigmentosa patients diagnosed with RP in a tertiary eye hospital. Full history and ocular examination were made. SS-OCT imaging was done for all eyes assessing the presence of cystoid macular edema, epiretinal membrane, macular holes, and external limiting membrane, ellipsoid zone status. Also, central macular thickness and choroidal vascular thickness were measured. Results The study was run on 161 eyes of 81 patients; 53 males and 28 females. The average age at examination was 26.1 (6–78) years. Twenty-six eyes (16.1%) were of syndromic RP patients, mostly Usher syndrome; 20 eyes (12.4%). The mean Logaritmic minimal angle of resolution (LogMAR) of Best Corrected Visual Acuity (BCVA)of the study sample was 0.66 ± 0.7. The most prevalent change was cystoid macular edema [28 eyes, (17.4%)], followed by epiretinal membrane [17eye, (10.6%)]. A macular hole was noted only in one eye (0.6%). Ellipsoid zone and external limiting membrane were absent in 55 eyes (35.0%) and 60 eyes 37.5%. Vitreous hyperreflective foci were found in 35 eyes (43.8%). LogMAR of BCVA was associated significantly with cystoid macular edema (p = 0.001), ellipsoid zone(p = 0.001), and external limiting membrane (p = 0.001). Conclusions Detailed SS-OCT assessment in Palestinian patients diagnosed with RP identified different morphologies from other populations. Cystoid macular edema and vitreous hyperreflective foci may reflect signs of early or intermediate stages of the disease. Disease progression can be monitored by measuring the length/width (area) of ellipsoid zone +/− external limiting membrane and choroidal vascular thickness, which should be evaluated serially using high-resolution OCT.

scholarly journals Regression of taxane-related cystoid macular edema after topical dorzolamide treatment: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Mitsuru Otsubo ◽  
Reiko Kinouchi ◽  
Takayuki Kamiya ◽  
Akitoshi Yoshida
Keyword(s):  
Visual Acuity ◽  
Side Effects ◽  
Macular Edema ◽  
Cystoid Macular Edema ◽  
Corrected Visual Acuity ◽  
Old Japanese ◽  
Multiple Metastases ◽  
Topical Dorzolamide ◽  
The Right ◽  
Best Corrected Visual Acuity

Abstract Background Cystoid macular edema is a rare, vision-threatening side effect of the taxane family of anticancer agents. There is no established treatment or standard treatment protocol for taxane-related cystoid macular edema. Here, we report two cases of taxane-related cystoid macular edema that were treated with topical dorzolamide. Case presentation In case 1, a 72-year-old Japanese woman with bilateral geographic choroiditis reported for a follow-up visit with a complaint of blurred vision in both eyes for 2 months after starting nanoparticle albumin-bound paclitaxel chemotherapy for multiple metastases of her breast cancer. Her best-corrected visual acuity had dropped from 1.2 to 0.9 in the right eye and from 1.0 to 0.4 in the left eye. Fundus examination showed no newly active geographic choroiditis lesion, but optical coherence tomography exhibited cystoid macular edema. We suspected taxane-related cystoid macular edema and terminated nanoparticle albumin-bound paclitaxel, and started topical dorzolamide treatment. Cystoid macular edema nearly resolved within 6 weeks in the right eye and within 10 weeks in the left eye after starting topical dorzolamide treatment. The resolution of cystoid macular edema without leaving a chorioretinal scar after discontinuation of paclitaxel confirmed our initial diagnosis of taxane-related cystoid macular edema. A few inconspicuous cystoid spaces persisted at the parafovea for a year after dorzolamide treatment ended, but regressed after restarting dorzolamide treatment without any side effects. Best-corrected visual acuity improved to 1.2 in the right eye and 1.0 in the left eye. In case 2, a 70-year-old Japanese man, who received nanoparticle albumin-bound paclitaxel for pancreatic cancer with multiple metastases, developed bilateral cystoid macular edema. Best-corrected visual acuity was 0.3 bilaterally. Cystoid macular edema resolved within 5 weeks after stopping nanoparticle albumin-bound paclitaxel and starting topical dorzolamide treatment confirming the diagnosis of taxane-related cystoid macular edema. Nine weeks later, best-corrected visual acuity improved to 0.8 in the right eye and 1.0 in the left eye. Conclusions Cystoid macular edema in each case resolved within a few months without any side effects using topical dorzolamide and terminating taxane-based chemotherapy. Topical dorzolamide appears to be a safe and effective treatment option for patients with taxane-related cystoid macular edema whose quality of life is threatened by visual disturbances.

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