Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injections
Purpose: To report two cases of diabetic macular edema (DME) treated with intravitreal faricimab injections (IVFs), including the assessment of retinal microaneurysms and extent of retinal capillary non-perfusion using fluorescein angiography (FA) and indocyanine green angiography (IA). Observations...
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Elsevier
2024-03-01
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| Series: | American Journal of Ophthalmology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993623001810 |
| _version_ | 1797301407665094656 |
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| author | Miki Sawa Norihiko Nakagawa Takuya Shunto Issei Nishiyama |
| author_facet | Miki Sawa Norihiko Nakagawa Takuya Shunto Issei Nishiyama |
| author_sort | Miki Sawa |
| collection | DOAJ |
| description | Purpose: To report two cases of diabetic macular edema (DME) treated with intravitreal faricimab injections (IVFs), including the assessment of retinal microaneurysms and extent of retinal capillary non-perfusion using fluorescein angiography (FA) and indocyanine green angiography (IA). Observations: Case 1: A 72-year-old man presented with aflibercept-resistant DME in the left eye, with a best-corrected visual acuity (BCVA) of 20/16. FA showed areas of retinal capillary non-perfusion and focal leakage in the macular area of the left eye. IA revealed numerous microaneurysms in the temporal region of the macula. Four consecutive monthly IVFs were administered to the left eye, and DME eventually diminished. After the loading phase, the BCVA was maintained at 20/16 with reduced visual distortion. FA showed improvement of macular leakage and stable retinal capillary non-perfusion areas, and the foveal avascular zone was clearly observed. The disappearance of numerous microaneurysms was confirmed on IA images.Case 2: An 80-year-old woman developed DME with macular vein occlusion in the left eye after panretinal laser photocoagulation for proliferative diabetic retinopathy. The patient's BCVA was 20/32. DME was resistant to subtenon triamcinolone injections. FA revealed focal areas of retinal capillary non-perfusion and persistent leakage in the macular area of the left eye. IA revealed scattered microaneurysms within the retinal arcade. Four consecutive monthly IVFs were administered to the left eye, and DME eventually diminished. After the loading phase, the BCVA was maintained at 20/32. FA showed improvement of macular leakage and stable retinal capillary non-perfusion areas. The reduction of microaneurysms was confirmed on IA images. Conclusions and importance: These case reports highlight the potential of faricimab as an alternative anti-vascular endothelial growth factor drug for treatment-resistant DME, including reduction of retinal microaneurysms and stabilization of the areas of retinal capillary non-perfusion. However, continuation of a robust treatment regimen may be required to achieve these objectives. |
| first_indexed | 2024-03-07T23:22:05Z |
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| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-03-07T23:22:05Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
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| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-ac1d3a26b19a485fa3d76e84b6432f5b2024-02-21T05:29:12ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-03-0133101973Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injectionsMiki Sawa0Norihiko Nakagawa1Takuya Shunto2Issei Nishiyama3Corresponding author. Eye Center, Sakai City Medical Center, 1-1-1 Ebaraji-cho, Nishi-ku, Sakai City, Osaka, 593-8304, Japan.; Eye Center, Sakai City Medical Center, 1-1-1 Ebaraji-cho, Nishi-ku, Sakai City, Osaka, JapanEye Center, Sakai City Medical Center, 1-1-1 Ebaraji-cho, Nishi-ku, Sakai City, Osaka, JapanEye Center, Sakai City Medical Center, 1-1-1 Ebaraji-cho, Nishi-ku, Sakai City, Osaka, JapanEye Center, Sakai City Medical Center, 1-1-1 Ebaraji-cho, Nishi-ku, Sakai City, Osaka, JapanPurpose: To report two cases of diabetic macular edema (DME) treated with intravitreal faricimab injections (IVFs), including the assessment of retinal microaneurysms and extent of retinal capillary non-perfusion using fluorescein angiography (FA) and indocyanine green angiography (IA). Observations: Case 1: A 72-year-old man presented with aflibercept-resistant DME in the left eye, with a best-corrected visual acuity (BCVA) of 20/16. FA showed areas of retinal capillary non-perfusion and focal leakage in the macular area of the left eye. IA revealed numerous microaneurysms in the temporal region of the macula. Four consecutive monthly IVFs were administered to the left eye, and DME eventually diminished. After the loading phase, the BCVA was maintained at 20/16 with reduced visual distortion. FA showed improvement of macular leakage and stable retinal capillary non-perfusion areas, and the foveal avascular zone was clearly observed. The disappearance of numerous microaneurysms was confirmed on IA images.Case 2: An 80-year-old woman developed DME with macular vein occlusion in the left eye after panretinal laser photocoagulation for proliferative diabetic retinopathy. The patient's BCVA was 20/32. DME was resistant to subtenon triamcinolone injections. FA revealed focal areas of retinal capillary non-perfusion and persistent leakage in the macular area of the left eye. IA revealed scattered microaneurysms within the retinal arcade. Four consecutive monthly IVFs were administered to the left eye, and DME eventually diminished. After the loading phase, the BCVA was maintained at 20/32. FA showed improvement of macular leakage and stable retinal capillary non-perfusion areas. The reduction of microaneurysms was confirmed on IA images. Conclusions and importance: These case reports highlight the potential of faricimab as an alternative anti-vascular endothelial growth factor drug for treatment-resistant DME, including reduction of retinal microaneurysms and stabilization of the areas of retinal capillary non-perfusion. However, continuation of a robust treatment regimen may be required to achieve these objectives.http://www.sciencedirect.com/science/article/pii/S2451993623001810Diabetic macular edemaIntravitreal faricimab injectionFluorescein angiographyIndocyanine angiographyIntravitreal anti-vascular endothelial growth factor |
| spellingShingle | Miki Sawa Norihiko Nakagawa Takuya Shunto Issei Nishiyama Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injections American Journal of Ophthalmology Case Reports Diabetic macular edema Intravitreal faricimab injection Fluorescein angiography Indocyanine angiography Intravitreal anti-vascular endothelial growth factor |
| title | Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injections |
| title_full | Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injections |
| title_fullStr | Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injections |
| title_full_unstemmed | Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injections |
| title_short | Two cases of diabetic macular edema with diminished areas of retinal non-perfusion and microaneurysms after intravitreal faricimab injections |
| title_sort | two cases of diabetic macular edema with diminished areas of retinal non perfusion and microaneurysms after intravitreal faricimab injections |
| topic | Diabetic macular edema Intravitreal faricimab injection Fluorescein angiography Indocyanine angiography Intravitreal anti-vascular endothelial growth factor |
| url | http://www.sciencedirect.com/science/article/pii/S2451993623001810 |
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