Allan KC, Hua HU, Singh AD, Yuan A. Rapid symptomatic and structural improvement of a retinal astrocytic hamartoma in response to anti-VEGF therapy: A case report.
Am J Ophthalmol Case Rep 2022;
27:101606. [PMID:
35692434 PMCID:
PMC9184888 DOI:
10.1016/j.ajoc.2022.101606]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/22/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose
To describe a patient with bilateral peripapillary astrocytic hamartomas with exudation of subretinal fluid into the macula and loss of vision without evidence of choroidal neovascularization. The patient rapidly responded to intravitreal bevacizumab injections resulting in reduced subretinal fluid and clinical improvement.
Observation
A 70-year-old female presented with worsening vision in her left eye due to subretinal fluid exudation from a peripapillary astrocytic hamartoma. The patient was treated with two doses of bevacizumab with rapid improvement in vision and resolution of subretinal fluid. Genetic testing was negative for common pathogenic variants for tuberous sclerosis and neurofibromatosis, which are highly associated with bilateral optic nerve and retinal astrocytic hamartomas.
Conclusion
Astrocytic hamartomas with exudation may be responsive to bevacizumab suggesting a dependence of these lesions on vascular endothelial growth factor (VEGF) independent of secondary choroidal neovascularization. Furthermore, this case describes a patient with bilateral astrocytic hamartomas without genetic or clinical confirmation of associated phakomatoses, such as tuberous sclerosis and neurofibromatosis.
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