ABSTRACT
INTRODUCTION: Choroidal neovascularization (CNV) is a rare complication after laser photocoagulation for central serous chorioretinopathy (CSCR).That's why , little is known about its management. Anti-VEGF therapy has emerged as the treatment of choice in patients with CNV. We report a case of a patient who developed iatrogenic CNV after having argon laser photocoagulation for a CSCR, treated with intravitreal injections of Bevacizumab. AIM: The goal of our paper is to show the efficacy and safety of the intravitreal injections of antiVEGF and discuss the alternative of argon laser photocoagulation to avoid complications. CASE PRESENTATION: A 35-year-old pregnant woman diagnosed in August 2014 with an acute CSCR in the right eye. The patient was treated by a focal photocoagulation of the leakage point . In December 2015, she was complaining of metamorphopsia in the same eye .The BCVA was 10/10 in the right eye , and the funduscopic examination showed agrayish-white neovascular membrane, which corresponded to the area of the previous photocoagulation.The fluorescein angiography , OCT and the OCT angiography demonstrated the choroidal neovascular membrane .The patient received 3 intravitreal injections of Bevacizumab at monthly intervals in the right eye.The patient was followed-up at regular intervals and she became asymptomatic during three years. CONCLUSION: Choroidal neovascualrization may be an iatrogenic complication after argon photocoagulation in CSCR. Intravitreal injections of anti VEGF appear to be a promising treatment option for iatrogenic CNV due to photocoagulation.
Subject(s)
Argon/therapeutic use , Central Serous Chorioretinopathy/therapy , Choroidal Neovascularization/etiology , Laser Coagulation/adverse effects , Adult , Bevacizumab/administration & dosage , Choroidal Neovascularization/diagnosis , Choroidal Neovascularization/drug therapy , Female , Fluorescein Angiography , Humans , Intravitreal Injections , Laser Coagulation/methods , Pregnancy , Pregnancy Complications/diagnosis , Pregnancy Complications/etiology , Pregnancy Complications/therapy , Tomography, Optical Coherence , Visual AcuityABSTRACT
INTRODUCTION: The transconjunctival 23-gauge vitrectomy without sutures (VTCSS) combines the advantages of the 20 and 25-gauge system. It currently represents the gold standard for the surgical management of vitreoretinal pathologies, especially in diabetic patients. AIM: Evaluate the anatomical and functional results of the VTCSS 23 gauge in diabetic tractionnal retinal detachment (DRT). METHODS: This is a retrospective study of patients undergoing vitrectomy 23 gauges from February 2015 to February 2017. Each patient a complete ophthalmological examination with collection of pre operative peroperative and postoperative data. The vitrectomy was performed by 3 ways through the 23-gauge cannula system Results :We collected 52 eyes presenting a DRT. The average age of patients was 50.62 years old. The average glycated hemoglobin (HBA1C) was 9.3%. The average time to treatment was 76.92 days. The results were as follows: For anatomical results: anatomical success rate was 92.30%. Functionally: A significant improvement in mean AV from 1/80 to 1.25 / 10 after surgery (p = 0.022), a statistically significant correlation between the final postoperative VA and the management delay (p <0.001); significant correlation between preoperative VA and final postoperative VA (p <0.001). CONCLUSION: The VTCSS 23 gauge is an effective and safe surgery for DRT surgery in diabetic patients with a gain in time and comfort for the patient.
