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Treatment of Macula Edema Complicated by Exudative Retinal Astrocytic Hamartomas in Patients with Tuberous Sclerosis
Ann Optom Contact Lens 2019;18:125-130
Published online December 25, 2019
© 2019 The Korean Optometry & Contact Lens Study Society

Jae Hyuck Kwak, MD, Rowoon Yi, MD, Young Jung Roh, MD, PhD, Young-Hoon Park, MD, PhD, Seung Yong Choi, MD

Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Correspondence to: Seung Yong Choi, MD
Department of Ophthalmology, College of Medicine, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul 06591, Korea
Tel: 82-2-3779-1848, Fax: 82-2-761-6869
E-mail: malisim@naver.com
Received October 28, 2019; Revised November 4, 2019; Accepted November 7, 2019.
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 report cases in which intravitreal vascular endothelial growth factor injections were improved secondary macular edema complicated by exudative retinal astrocytic hamartomas in patients with tuberous sclerosis.
Case summary: (Case 1) A 27-year-old male patient who was diagnosed with tuberous sclerosis and was referred for ophthalmologic examination. The best corrected visual acuity (BCVA) was 0.63 and macular edema with epiretinal membrane and retinal astrocytic hamartomas were observed on his right eye. And also fluorescent leakage was observed in fluorescein angiography. After one month of intravitreal ranibizumab injection, the BCVA in the right eye was 1.0. Amount of the macular edema was decreased in the optical coherence tomography and remained stable for 6 months. (Case 2) A 34-year-old female patient presented with sudden left visual loss. The patient had a history of 10 years old tuberous sclerosis and had facial angiofibroma. The BCVA was 1.0 in the right eye and 0.2 in the left eye. Bilateral retinal astrocytic hamartomas and vitreous hemorrhage in the left eye were observed. Intravitreal bevacizumab injection was performed twice at her left eye and then she recovered to the BCVA of 1.0 in the left eye. Two months later, however, the visual loss in the left eye recurred. After nine cycles of monthly intravitreal bevacizumab injection in the left eye with retinal astrocytic hamartomas, macular edema was decreased.
Conclusions: Intravitreal injection of anti-vascular endothelial growth factors may improve secondary macula edema complicated by exudative retinal astrocytic hamartomas of tuberous sclerosis.
Keywords : Tuberous sclerosis; Retinal astrocytic hamartoma


December 2019, 18 (4)