A Brazilian case of exudative perifoveal vascular anomalous complex responsive to aflibercept intravitreal injections
PURPOSE: To report a case of exudative perifoveal exudative vascular anomalous complex (ePVAC) in a Brazilian healthy patient that underwent a complete resolution after aflibercept intravitreal injections.
CASE DESCRIPTION: A 41-year-old healthy Brazilian man complained of acute central vision loss in his right eye (RE). Fundus examination showed a perifoveal hemorrhagic aneurysmal lesion, accompanied by several hard exudates in RE. On fluorescein angiography, these abnormalities showed a progressive hyperfluorescence with surrounding leakage. Optical coherence tomography (OCT) revealed a deep, perifoveal hyporeflective cystic space with a hyperreflective wall and hyperreflective material inside of fibrin-like aspect. Around this aneurism, intraretinal hyporeflective spaces suggestive of exudation were detected. Nor pathological flow signal, or telangiectatic dilations were evidenced on OCT-angiography. Therefore, a diagnosis of exudative ePVAC in RE was hypothesized. After an initial observation, the patient underwent three monthly aflibercept intravitreal injections (0.05 ml/2 mg), with a significative anatomical and functional improvement after two weeks from first dose. On last follow-up at five months from baseline, patient experienced no evidence of new exudation and a stable visual acuity.
DISCUSSION: Placental growth factor (PlGF) may impact on pericytes' dropout, and thus on ePVAC development. In contrast to the other anti-VEGF drugs, aflibercept is the only molecule contrasting PlGF. Therefore, aflibercept would act on ePVAC not as an anti-VEGF drug, but rather as an anti-PlGF one.
CONCLUSION: This report encouraged the use of aflibercept as a therapeutic option for ePVAC. Further studies are required to confirm our result and the impact of PlGF on ePVAC pathogenesis.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:34 |
|---|---|
| Enthalten in: |
European journal of ophthalmology - 34(2024), 2 vom: 25. Feb., Seite NP68-NP72 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Cunha de Souza, Eduardo [VerfasserIn] |
|---|
| Links: |
|---|
| Anmerkungen: |
Date Completed 27.02.2024 Date Revised 27.02.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/11206721231200116 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM361690908 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM361690908 | ||
| 003 | DE-627 | ||
| 005 | 20240229163604.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/11206721231200116 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1308.xml |
| 035 | |a (DE-627)NLM361690908 | ||
| 035 | |a (NLM)37671424 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Cunha de Souza, Eduardo |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A Brazilian case of exudative perifoveal vascular anomalous complex responsive to aflibercept intravitreal injections |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 27.02.2024 | ||
| 500 | |a Date Revised 27.02.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: To report a case of exudative perifoveal exudative vascular anomalous complex (ePVAC) in a Brazilian healthy patient that underwent a complete resolution after aflibercept intravitreal injections | ||
| 520 | |a CASE DESCRIPTION: A 41-year-old healthy Brazilian man complained of acute central vision loss in his right eye (RE). Fundus examination showed a perifoveal hemorrhagic aneurysmal lesion, accompanied by several hard exudates in RE. On fluorescein angiography, these abnormalities showed a progressive hyperfluorescence with surrounding leakage. Optical coherence tomography (OCT) revealed a deep, perifoveal hyporeflective cystic space with a hyperreflective wall and hyperreflective material inside of fibrin-like aspect. Around this aneurism, intraretinal hyporeflective spaces suggestive of exudation were detected. Nor pathological flow signal, or telangiectatic dilations were evidenced on OCT-angiography. Therefore, a diagnosis of exudative ePVAC in RE was hypothesized. After an initial observation, the patient underwent three monthly aflibercept intravitreal injections (0.05 ml/2 mg), with a significative anatomical and functional improvement after two weeks from first dose. On last follow-up at five months from baseline, patient experienced no evidence of new exudation and a stable visual acuity | ||
| 520 | |a DISCUSSION: Placental growth factor (PlGF) may impact on pericytes' dropout, and thus on ePVAC development. In contrast to the other anti-VEGF drugs, aflibercept is the only molecule contrasting PlGF. Therefore, aflibercept would act on ePVAC not as an anti-VEGF drug, but rather as an anti-PlGF one | ||
| 520 | |a CONCLUSION: This report encouraged the use of aflibercept as a therapeutic option for ePVAC. Further studies are required to confirm our result and the impact of PlGF on ePVAC pathogenesis | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a age-related macular degeneration < RETINA | |
| 650 | 4 | |a anatomy/biochemistry/physiology < RETINA | |
| 650 | 4 | |a retina - medical therapies < RETINA | |
| 650 | 4 | |a retinal pathology / research < RETINA | |
| 650 | 4 | |a retinal telangietasias/macroaneurysms < RETINA | |
| 650 | 7 | |a aflibercept |2 NLM | |
| 650 | 7 | |a 15C2VL427D |2 NLM | |
| 650 | 7 | |a Placenta Growth Factor |2 NLM | |
| 650 | 7 | |a 144589-93-5 |2 NLM | |
| 650 | 7 | |a Receptors, Vascular Endothelial Growth Factor |2 NLM | |
| 650 | 7 | |a EC 2.7.10.1 |2 NLM | |
| 650 | 7 | |a Recombinant Fusion Proteins |2 NLM | |
| 650 | 7 | |a Angiogenesis Inhibitors |2 NLM | |
| 700 | 1 | |a Tombolini, Beatrice |e verfasserin |4 aut | |
| 700 | 1 | |a Sacconi, Riccardo |e verfasserin |4 aut | |
| 700 | 1 | |a Bandello, Francesco |e verfasserin |4 aut | |
| 700 | 1 | |a Querques, Giuseppe |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European journal of ophthalmology |d 1996 |g 34(2024), 2 vom: 25. Feb., Seite NP68-NP72 |w (DE-627)NLM012606944 |x 1724-6016 |7 nnns |
| 773 | 1 | 8 | |g volume:34 |g year:2024 |g number:2 |g day:25 |g month:02 |g pages:NP68-NP72 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/11206721231200116 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 34 |j 2024 |e 2 |b 25 |c 02 |h NP68-NP72 | ||