Annals of Optometry and Contact Lens 2019;18(4):125-130.
Published online December 25, 2019.
결절성경화증 환자에서 삼출성 망막 성상세포과오종에 병발하여 발생한 황반부종의 치료
곽재혁, 이로운, 노영정, 박영훈, 최승용
가톨릭대학교 의과대학 안과학교실
Treatment of Macula Edema Complicated by Exudative Retinal Astrocytic Hamartomas in Patients with Tuberous Sclerosis
Jae Hyuck Kwak, Rowoon Yi, Young Jung Roh, Young-Hoon Park, Seung Yong Choi
Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea
Received: 28 October 2019   • Revised: 4 November 2019   • Accepted: 7 November 2019
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.
Key Words: Tuberous sclerosis; Retinal astrocytic hamartoma
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