Intravitreal aflibercept for the treatment of choroidal neovascularization associated with rubella retinopathy

• Published in: International ophthalmology 2019-02, Vol.39 (2), p.477-484
• Main Authors: Kiziltoprak, Hasan, Yetkin, Esat, Tekin, Kemal, Koc, Mustafa, Akalin, İrfan, Teke, Mehmet Yasin
• Format: Article
• Language: English
• Subjects: Acuity; Angiography; Case Report; Case reports; Eye; Eye (anatomy); Fluorescein; Fluorescence; Hemorrhage; Injection; Medicine; Medicine & Public Health; Ophthalmology; Optical Coherence Tomography; Retina; Retinopathy; Rubella; Salts; Vascularization; Visual acuity
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-018-0830-5

Purpose To report a case of choroidal neovascularization (CNV) associated with rubella retinopathy (RR) treated with intravitreal aflibercept. Case presentation A 15-year-old girl presented a complaint of visual decrease in her left eye. She had a history of hearing decrease since she was 1 year old in addition to patent ductus arteriosus. On ocular examination, the best corrected visual acuity (BCVA) was 20/20 in the right eye and 20/400 in the left eye. Dilated fundus examinations revealed a classic salt-and-pepper appearance in both eyes and a whitish subretinal lesion with retinal hemorrhages in the left macula. Fundus fluorescein angiography (FFA) of the left eye illustrated a pattern of diffuse spotty fluorescence with an active subfoveal CNV lesion, that hyperfluoresces in the early phases of the FFA, maintains well-demarcated borders, and leaks. Spectral domain optical coherence tomography (SD-OCT) revealed thickened and elevated retinal layers at the macula due to the subretinal and intraretinal fluid with foveal and extrafoveal protruding hyper-reflective lesion in the left eye. Single dose of intravitreal aflibercept was performed to the left eye and at the first month after the injection, the BCVA improved to 20/100 and the OCT revealed scar formation. At the follow-up visits, the macula was similar to those at the first month post-injection, and the BCVA was preserved. No additional injections were needed. Conclusion Intravitreal aflibercept may be a treatment alternative, which provides satisfactory anatomical and functional results and leads to a better visual acuity in cases with RR complicated by CNV.