MASSIVE RETINAL NEOVASCULARIZATION IN VON HIPPEL–LINDAU DISEASE: ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR, VITRECTOMY, IMMUNOHISTOCHEMISTRY, AND OPTICAL COHERENCE TOMOGRAPHY FEATURES.

Autor: Kreuz, André Carvalho, Zacharias, Leandro Cabral, Oliveira, Raíza Dantas de Lira, Ferreira, Bruno Fortaleza de Aquino, de Lima, Patrícia Picciarelli, Pimentel, Sérgio Luís Gianotti
Zdroj: Retinal Cases & Brief Reports; May2022, Vol. 16 Issue 3, p296-299, 4p
Abstrakt: Supplemental Digital Content is Available in the Text. A patient with massive retinal neovascularization and macular traction associated with von Hippel–Lindau disease was submitted to anti–vascular endothelial growth factor therapy and vitrectomy, resulting in visual and anatomical improvement. Histopathological and immunohistochemical findings and follow-up data are presented. Purpose: To report a rare presentation of ocular von Hippel–Lindau disease associated with a massive epiretinal vascular proliferation over the macula removed by vitrectomy and submitted to histological analysis. Methods: Interventional case report. Results: A 13-year-old woman with von Hippel–Lindau disease reported progressive visual loss in the right eye over the preceding 6 months. Best-corrected visual acuity was 20/100 in the right eye. Fundoscopy showed retinal neovascularization (RNV) with macular traction and a small superotemporal hemangioblastoma. Spectral-domain optical coherence tomography confirmed increased macular thickness and macular traction secondary to RNV. Bevacizumab was injected intravitreally, resulting in partial regression of RNV. Five days after the injection, the patient underwent complete removal of fibrovascular proliferation via pars plana vitrectomy, followed by peripheral tumor photocoagulation. The specimen was subjected to histopathological and immunohistochemical analyses. At 2 years of follow-up, vision had improved to 20/30, and anatomical improvement was confirmed on both fundoscopy and spectral-domain optical coherence tomography. Conclusion: Ocular von Hippel–Lindau disease may be associated with RNV and macular traction. In such cases, RNV is likely responsive to anti–vascular endothelial growth factor and may be removed surgically along a cleavage plane between the tissue proliferation and the inner retina. In the reported case, the procedure was found to be safe and associated with macular anatomical improvement and vision recovery. [ABSTRACT FROM AUTHOR]
Databáze: Supplemental Index