Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions
Purpose: Acquired vitelliform lesions (AVLs) are associated with age-related macular degeneration and other variable macular disorders. AVLs often lead to outer retinal atrophy, sometimes accompanying a macular hole and choroidal neovascularization. The purpose of this study was to report a rare cas...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-06-01
|
| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993620300244 |
| _version_ | 1818306454099066880 |
|---|---|
| author | Nana Yata Tsutomu Yasukawa Mihoko Kawamura Yoshio Hirano Yuichiro Ogura |
| author_facet | Nana Yata Tsutomu Yasukawa Mihoko Kawamura Yoshio Hirano Yuichiro Ogura |
| author_sort | Nana Yata |
| collection | DOAJ |
| description | Purpose: Acquired vitelliform lesions (AVLs) are associated with age-related macular degeneration and other variable macular disorders. AVLs often lead to outer retinal atrophy, sometimes accompanying a macular hole and choroidal neovascularization. The purpose of this study was to report a rare case with bilateral AVLs, in which one eye had accompanied a macular hole and the second eye a serous pigment epithelial detachment (sPED). Observations: A 66-year-old woman complained of bilateral metamorphopsia. AVLs were observed in the right eye and a flat sPED in the left eye. The best-corrected visual acuity (BCVA) was 20/17 in both eyes. Fluorescein angiography revealed local leakage in the right eye and pattern dystrophy-like hypofluorescence in both eyes. The sPED progressed with AVLs in the left eye and was treated with a combination therapy of intravitreal aflibercept, a sub-Tenon's injection of triamcinolone acetonide, and photodynamic therapy (IVA/STTA/PDT), which successfully flattened the sPED and sustained good vision for 4 years. The right eye was treated with intravitreal ranibizumab and tissue plasminogen activator, which enhanced absorption of the vitelliform material. However, 14 months later, a macular hole with typical metamorphopsia formed above a subretinal fibrotic scar at the vitelliruptive stage. Although pars plana vitrectomy closed the macular hole, enlargement of the outer retinal atrophy worsened the BCVA to 20/100. Conclusions and importance: We successfully treated one eye with a sPED with AVLs using the combination therapy of IVA/STTA/PDT, while the second eye with a macular hole secondary to AVLs ultimately developed outer retinal atrophy with visual loss. |
| first_indexed | 2024-12-13T06:42:44Z |
| format | Article |
| id | doaj.art-9c87d46e2dad4e70b6217fe3e0bb9201 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-13T06:42:44Z |
| publishDate | 2020-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-9c87d46e2dad4e70b6217fe3e0bb92012022-12-21T23:56:23ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362020-06-0118Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesionsNana Yata0Tsutomu Yasukawa1Mihoko Kawamura2Yoshio Hirano3Yuichiro Ogura4Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanCorresponding author. Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, Aichi, 467-8601, Japan.; Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanDepartment of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanDepartment of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanDepartment of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, JapanPurpose: Acquired vitelliform lesions (AVLs) are associated with age-related macular degeneration and other variable macular disorders. AVLs often lead to outer retinal atrophy, sometimes accompanying a macular hole and choroidal neovascularization. The purpose of this study was to report a rare case with bilateral AVLs, in which one eye had accompanied a macular hole and the second eye a serous pigment epithelial detachment (sPED). Observations: A 66-year-old woman complained of bilateral metamorphopsia. AVLs were observed in the right eye and a flat sPED in the left eye. The best-corrected visual acuity (BCVA) was 20/17 in both eyes. Fluorescein angiography revealed local leakage in the right eye and pattern dystrophy-like hypofluorescence in both eyes. The sPED progressed with AVLs in the left eye and was treated with a combination therapy of intravitreal aflibercept, a sub-Tenon's injection of triamcinolone acetonide, and photodynamic therapy (IVA/STTA/PDT), which successfully flattened the sPED and sustained good vision for 4 years. The right eye was treated with intravitreal ranibizumab and tissue plasminogen activator, which enhanced absorption of the vitelliform material. However, 14 months later, a macular hole with typical metamorphopsia formed above a subretinal fibrotic scar at the vitelliruptive stage. Although pars plana vitrectomy closed the macular hole, enlargement of the outer retinal atrophy worsened the BCVA to 20/100. Conclusions and importance: We successfully treated one eye with a sPED with AVLs using the combination therapy of IVA/STTA/PDT, while the second eye with a macular hole secondary to AVLs ultimately developed outer retinal atrophy with visual loss.http://www.sciencedirect.com/science/article/pii/S2451993620300244Anti-vascular endothelial growth factor therapyMacular holePhotodynamic therapySerous retinal pigment epithelial detachmentVitelliform lesionsVitrectomy |
| spellingShingle | Nana Yata Tsutomu Yasukawa Mihoko Kawamura Yoshio Hirano Yuichiro Ogura Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions American Journal of Ophthalmology Case Reports Anti-vascular endothelial growth factor therapy Macular hole Photodynamic therapy Serous retinal pigment epithelial detachment Vitelliform lesions Vitrectomy |
| title | Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions |
| title_full | Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions |
| title_fullStr | Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions |
| title_full_unstemmed | Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions |
| title_short | Macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions |
| title_sort | macular hole and serous pigment epithelial detachment in bilateral acquired vitelliform lesions |
| topic | Anti-vascular endothelial growth factor therapy Macular hole Photodynamic therapy Serous retinal pigment epithelial detachment Vitelliform lesions Vitrectomy |
| url | http://www.sciencedirect.com/science/article/pii/S2451993620300244 |
| work_keys_str_mv | AT nanayata macularholeandserouspigmentepithelialdetachmentinbilateralacquiredvitelliformlesions AT tsutomuyasukawa macularholeandserouspigmentepithelialdetachmentinbilateralacquiredvitelliformlesions AT mihokokawamura macularholeandserouspigmentepithelialdetachmentinbilateralacquiredvitelliformlesions AT yoshiohirano macularholeandserouspigmentepithelialdetachmentinbilateralacquiredvitelliformlesions AT yuichiroogura macularholeandserouspigmentepithelialdetachmentinbilateralacquiredvitelliformlesions |