Abstract
The association between choroidal neovascularization (CNV) and retinal vein occlusive disease is uncommon. Before the introduction of anti-vascular endothelial growth factor (VEGF) drugs, photodynamic therapy (PDT) was used, with conflicting functional results. We report a case of a 69-year-old male patient who came to our attention for macular edema in hemiretinal vein occlusion. Fluorescein angiogram showed presence of venous collaterals, but the pattern of the edema was atypical; optical coherence tomography (OCT) and indocyanine green angiography (ICG) were used to confirm the diagnosis of CNV. A chorio-retinal shunt was demonstrated. The autofluorescence technique was used to predict the risk of CNV in the fellow eye. PDT was performed twice, but after the second cycle, patient developed choroidal ischemia and the visual outcomes were poor. The temporal course of CNV, the presence of a chorio-retinal shunt, and the autofluorescence pattern in the fellow eye let us to speculate that the CNV was related to the vascular occlusive process. We can speculate that the overexpression of VEGF induced by local ischemia and inflammation can make these patients more likely to have CNV. However, to our knowledge, there are no accurate estimates of the incidence of CNV in other retinal vascular diseases, such as diabetic retinopathy.
References
Bindewald A, Bird AC, Dandekar SS et al (2005) Classification of fundus autofluorescence patterns in early age-related macular disease. Investig Ophthalmol Vis Sci 46(9):3309–3314. doi:10.1167/iovs.04-0430
Boscia F, Parodi MB, Furino C, Reibaldi M, Sborgia C (2006) Photodynamic therapy with verteporfin for retinal angiomatous proliferation. Graefes Arch Clin Exp Ophthalmol 244(10):1224–1232. doi:10.1007/s00417-005-0205-2
DiLoreto DA Jr, Goldberg MF, Bressler NM (2004) Choroidal neovascularization after central retinal vein occlusion in a 47-year-old man. Arch Ophthalmol 122(9):1398–1401. doi:10.1001/archopht.122.9.1398
Eandi CM, Piccolino FC, Ventre L, Grignolo FM (2002) Photodynamic therapy for choroidal neovascularization in eyes with retinal vascular disorders. Retina 22(4):495–498. doi:10.1097/00006982-200208000-00016
Isola V, Pece A, Battaglia Parodi M (2006) Choroidal ischemia after photodynamic therapy with verteporfirin for choroidal neovascularization. Am J Ophthalmol 142(4):680–683. doi:10.1016/j.ajo.2006.04.028
(1999) Photodynamic therapy of subfoveal choroidal neovascularization in age-related macular degeneration with verteporfin: one-year results of 2 randomized clinical trials—TAP report. Treatment of age-related macular degeneration with photodynamic therapy (TAP) Study Group. Arch Ophthalmol 117(10):1329–1345
Shortt AJ, Howell K, O’Brien C, McLoughlin P (2004) Chronic systemic hypoxia causes intra-retinal angiogenesis. J Anat 205(5):349–356. doi:10.1111/j.0021-8782.2004.00351.x
Acknowledgment
We are very grateful to Massimo for his contagious enthusiasm for the study of macular diseases. Thank you for your intuitions and your sincere friendship.
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Fea, A., Grosso, A., Mollo, M. et al. Subfoveal choroidal neovascularization in a patient with hemicentral vein occlusion. Int Ophthalmol 30, 207–210 (2010). https://doi.org/10.1007/s10792-009-9306-y
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DOI: https://doi.org/10.1007/s10792-009-9306-y