1
|
Pan WW, Tracey BM, Jayasundera KT, Fahim AT. Autoantibodies Against Bestrophin in Non-Paraneoplastic Acute Exudative Polymorphous Vitelliform Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2024; 55:51-54. [PMID: 38189803 DOI: 10.3928/23258160-20231108-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Acute exudative polymorphous vitelliform maculopathy (AEPVM) has recently been identified as a paraneoplastic manifestation of various cancers. Yet, the first reported cases of AEPVM in the literature were reported in seemingly healthy individuals. It is not clear whether those individuals harbored unidentified mutations or occult cancers, or truly represented a separate subset of AEPVM. Here, we report two cases of mutation-negative, autoantibody-positive non-paraneoplastic AEPVM. We present multimodal ocular imaging to demonstrate the presentation of this subset of AEPVM. [Ophthalmic Surg Lasers Imaging Retina 2024;55:51-54.].
Collapse
|
2
|
Fernandes JS, Gomes PP, Neves P, Marques JP. Idiopathic acute exudative polymorphous vitelliform maculopathy: the importance of multimodal imaging, systemic workup and genetic testing. BMJ Case Rep 2023; 16:e253969. [PMID: 37380373 PMCID: PMC10410924 DOI: 10.1136/bcr-2022-253969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
The authors describe a case of acute exudative polymorphous vitelliform maculopathy (AEPVM) in an otherwise healthy man in his 60s complaining of subacute bilateral blurred vision. At examination, best-corrected visual acuity was 20/32 in the right eye and 20/40 in the left eye. Bilateral central large serous detachments with inferior meniscus-like deposition of a vitelliform-like material were observed at funduscopy and confirmed by spectral-domain optical coherence tomography. Small vitelliform-like lesions along the temporal superior vascular arcades were also seen. The lesions with vitelliform appearance appeared hyperautofluorescent on fundus autofluorescence. A complete systemic workup and genetic testing were performed and the diagnosis of idiopathic AEPVM was established. Six months later, a complete resolution of the lesions was observed.
Collapse
Affiliation(s)
- Joana Silva Fernandes
- Ophthalmology Department, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Pedro Prata Gomes
- Ophthalmology Department, Centro Hospitalar de Setubal EPE, Setubal, Portugal
| | - Pedro Neves
- Ophthalmology Department, Centro Hospitalar de Setubal EPE, Setubal, Portugal
| | - João Pedro Marques
- Ophthalmology Department, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| |
Collapse
|
3
|
Kowallick A, Koziolek M, Neß T, Feltgen N, Hoerauf H, Bemme S. [Metallic shiny visual phenomena in a female patient with pancreatic cancer]. DIE OPHTHALMOLOGIE 2023; 120:309-313. [PMID: 35925323 DOI: 10.1007/s00347-022-01635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/30/2022] [Indexed: 11/25/2022]
Affiliation(s)
- Antonia Kowallick
- Klinik für Augenheilkunde, Universitätsmedizin Göttingen, Göttingen, Deutschland.
| | - Michael Koziolek
- Klinik für Nephrologie und Rheumatologie, Zentrum Innere Medizin, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Thomas Neß
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - Nicolas Feltgen
- Klinik für Augenheilkunde, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Hans Hoerauf
- Klinik für Augenheilkunde, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Sebastian Bemme
- Klinik für Augenheilkunde, Universitätsmedizin Göttingen, Göttingen, Deutschland
| |
Collapse
|
4
|
Non-vasogenic cystoid maculopathies. Prog Retin Eye Res 2022; 91:101092. [PMID: 35927124 DOI: 10.1016/j.preteyeres.2022.101092] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 05/30/2022] [Accepted: 06/01/2022] [Indexed: 11/23/2022]
Abstract
Besides cystoid macular edema due to a blood-retinal barrier breakdown, another type of macular cystoid spaces referred to as non-vasogenic cystoid maculopathies (NVCM) may be detected on optical coherence tomography but not on fluorescein angiography. Various causes may disrupt retinal cell cohesion or impair retinal pigment epithelium (RPE) and Müller cell functions in the maintenance of retinal dehydration, resulting in cystoid spaces formation. Tractional causes include vitreomacular traction, epiretinal membranes and myopic foveoschisis. Surgical treatment does not always allow cystoid space resorption. In inherited retinal dystrophies, cystoid spaces may be part of the disease as in X-linked retinoschisis or enhanced S-cone syndrome, or occur occasionally as in bestrophinopathies, retinitis pigmentosa and allied diseases, congenital microphthalmia, choroideremia, gyrate atrophy and Bietti crystalline dystrophy. In macular telangiectasia type 2, cystoid spaces and cavitations do not depend on the fluid leakage from telangiectasia. Various causes affecting RPE function may result in NVCM such as chronic central serous chorioretinopathy and paraneoplastic syndromes. Non-exudative age macular degeneration may also be complicated by intraretinal cystoid spaces in the absence of fluorescein leakage. In these diseases, cystoid spaces occur in a context of retinal cell loss. Various causes of optic atrophy, including open-angle glaucoma, result in microcystoid spaces in the inner nuclear layer due to a retrograde transsynaptic degeneration. Lastly, drug toxicity may also induce cystoid maculopathy. Identifying NVCM on multimodal imaging, including fluorescein angiography if needed, allows guiding the diagnosis of the causative disease and choosing adequate treatment when available.
Collapse
|
5
|
Kang L, Wan C. Paraneoplastic syndrome in neuroophthalmology. J Neurol 2022; 269:5272-5282. [PMID: 35779086 DOI: 10.1007/s00415-022-11247-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/19/2022] [Accepted: 06/19/2022] [Indexed: 12/16/2022]
Abstract
Paraneoplastic syndrome is a group of clinical symptoms that occur in the state of systemic malignant tumors. Paraneoplastic syndrome of the nervous system can affect any part of the central and peripheral nervous system and may also affect the eyes. In neuroophthalmology, paraneoplastic syndrome has a variety of manifestations that can affect both the afferent and efferent visual systems. The afferent system may involve the optic nerve, retina and uvea; the efferent system may involve eye movement, neuromuscular joints or involuntary eye movements and pupil abnormalities and may also have other neurological symptoms outside the visual system. This article discusses the clinical manifestations, pathological mechanisms, detection methods and treatment methods of paraneoplastic syndrome in neuroophthalmology. The performance of paraneoplastic syndrome is diverse, the diagnosis is difficult, and the treatment should be considered systematically. Differential diagnosis, optimal evaluation and management of these manifestations is not only the key to treatment but also a challenge.
Collapse
Affiliation(s)
- Longdan Kang
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Chao Wan
- Department of Ophthalmology, The First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
| |
Collapse
|
6
|
Kalafatis NE, Agrawal KU, Ehya H, Shields CL. Cytology-Proven Primary Vitreoretinal Lymphoma in a Patient With Paraneoplastic Cloudy Vitelliform Submaculopathy. JAMA Ophthalmol 2022; 140:744-745. [PMID: 35616953 DOI: 10.1001/jamaophthalmol.2022.1554] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Nicholas E Kalafatis
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kushal U Agrawal
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Hormoz Ehya
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| |
Collapse
|
7
|
Paraneoplastic ocular syndrome: a pandora's box of underlying malignancies. Eye (Lond) 2021; 36:1355-1367. [PMID: 34345027 DOI: 10.1038/s41433-021-01676-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 06/28/2021] [Indexed: 02/06/2023] Open
Abstract
Paraneoplastic syndromes affecting the visual system are a group of conditions that arise in the systemic malignancy framework. In this review, we have provided a detailed and comprehensive overview of the published literature on the various ophthalmic paraneoplastic manifestations. A systematic review of many databases has been performed to identify ample literature on the paraneoplastic syndromes related to ophthalmology. We have discussed here the clinical features, pathogenesis, and treatment strategies of various ophthalmic paraneoplastic syndromes. It can be challenging to distinguish these disorders from their non-paraneoplastic counterparts and to determine the appropriate systemic assessment for the tumour responsible, to have a proper approach towards the management of the syndrome. METHOD: We searched PubMed, Science Direct and Journal of Ophthalmology for studies published in English between 1995 and April 2020, incorporating the general search term "paraneoplastic ocular syndrome" with connecting terms relevant to subheadings-e.g. Key search terms were cancer-associated retinopathy, (CAR), melanoma-associated retinopathy, (MAR), paraneoplastic retinopathy, autoimmune retinopathy, autoimmune-related retinopathy, and optic neuropathy, (ARRON), acute zonal occult outer retinopathy, (AZOOR), paraneoplastic vitelliform maculopathy, paraneoplastic vitelliform retinopathy, bilateral diffuse uveal melanocytic proliferation, (BDUMP), paraneoplastic optic neuropathy, (PON), polyneuropathy, organomegaly, endocrinopathy, monoclona gammopathy, and skin changes syndrome (POEMS) and various other terms. References from identified studies have been reviewed and included if deemed appropriate, valid, and scientifically important. If referenced in a selected English paper, we contemplated papers in other languages too. We preferentially selected papers that have been published in the last 10 years, but we have included relevant older references.
Collapse
|
8
|
Gameiro Filho AR, Sturzeneker G, Rodriguez EEC, Maia A, Morales MC, Belfort RN. Acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) associated with choroidal melanoma. Int J Retina Vitreous 2021; 7:27. [PMID: 33795031 PMCID: PMC8017785 DOI: 10.1186/s40942-021-00300-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/23/2021] [Indexed: 11/30/2022] Open
Abstract
Background To report a case of acute exudative polymorphous paraneoplastic vitelliform maculopathy in a patient with a history of choroidal melanoma, with metastases to the pancreas, liver, and central nervous system. Case presentation A 63-year-old patient, with a history of enucleation of the right eye due to choroidal melanoma, complained of progressive visual loss during a follow-up visit. Fundoscopic examination revealed multiple small areas of serous retinal detachment scattered throughout the posterior pole and ancillary tests confirmed the diagnosis of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM). Screening for systemic metastases showed pancreatic, hepatic, and central nervous system involvement. Conclusions We describe a rare case of acute exudative polymorphous paraneoplastic vitelliform maculopathy, which should be considered in patients with or without a history of melanoma, who have vitelliform retinal detachments. Nevertheless, no previous reviews of literature have shown a correlation between AEPPVM and pancreatic metastasis.
Collapse
Affiliation(s)
- Aluisio Rosa Gameiro Filho
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil.
| | - Guilherme Sturzeneker
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - Ever Ernesto Caso Rodriguez
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - André Maia
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - Melina Correia Morales
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| | - Rubens N Belfort
- Ophthalmology Department, Federal University of São Paulo (Unifesp-EPM), Rua Botucatu, 822, São Paulo, SP, 04023-062, Brazil
| |
Collapse
|
9
|
Yu H, Ma X, Tong N, Zhou Z, Zhang Y. Acute exudative paraneoplastic polymorphous vitelliform maculopathy in a patient with thymoma, myasthenia gravis, and polymyositis. Eur J Ophthalmol 2021; 32:NP56-NP61. [PMID: 33619978 DOI: 10.1177/1120672121994042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
IMPORTANCE This is the first reported case of acute exudative paraneoplastic polymorphous vitelliform maculopathy (AEPPVM) in a patient with thymoma, accompanied by myasthenia gravis (MG) and polymyositis. OBJECTIVE To examine the pathogenesis of ocular disease in a patient with yolk-like fundus lesions and thymoma, MG, and polymyositis throughout the body based on clinical manifestations, diagnosis, differential diagnosis, and genetic testing to determine the appropriate treatment course. DESIGN, SETTING, AND PARTICIPANTS We describe a 63-year-old woman who presented to our tertiary medical center with a 3-month history of reduced visual acuity in both eyes. Concurrent fundoscopy revealed a 2.0 × 1.7-mm, unifocal, yellow, round vitelliform lesion in the macular region, surrounded by multifocal, shallow, yellow-white pockets of subretinal fluid. The patient's medical history included thymoma with thymectomy treatment, combined with pericardiectomy and postoperative radiotherapy (20 years prior), followed by a diagnosis of MG with suspect thymic association (15 years prior). Three years prior, the patient had been diagnosed with polymyositis related to paraneoplastic syndrome; 1 year prior, she had been examined for pleural thickening due to suspected metastatic tumor. RESULTS On her most recent follow-up visit at 3 months after initial diagnosis, the patient was stable with no clinically significant progression in ocular or systemic conditions.
Collapse
Affiliation(s)
- He Yu
- Ophthalmologic Center, Qingdao Municipal Hospital, Qingdao, Shandong, P.R. China.,Graduate School, Dalian Medical University, Dalian, Liaoning, P.R. China
| | - Xinyu Ma
- Ophthalmologic Center, Qingdao Municipal Hospital, Qingdao, Shandong, P.R. China.,Graduate School, Dalian Medical University, Dalian, Liaoning, P.R. China
| | - Nianting Tong
- Ophthalmologic Center, Qingdao Municipal Hospital, Qingdao, Shandong, P.R. China
| | - Zhanyu Zhou
- Ophthalmologic Center, Qingdao Municipal Hospital, Qingdao, Shandong, P.R. China
| | - Yu Zhang
- Ophthalmologic Center, Qingdao Municipal Hospital, Qingdao, Shandong, P.R. China.,The Affiliated Municipal Hospital of Qingdao University, Qingdao, Shandong, P.R. China
| |
Collapse
|
10
|
Mueller CM, Hojjatie SL, Lawson DH, Jain N, Robinson J, Khan MK, Yushak ML, O'Keefe GAD. Clinical Correlation between Acute Exudative Polymorphous Paraneoplastic Vitelliform Maculopathy and Metastatic Melanoma Disease Activity: A 48-month Longitudinal Case Report. Ocul Immunol Inflamm 2020; 30:330-337. [PMID: 33021420 DOI: 10.1080/09273948.2020.1813782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Longitudinal evaluation of acute exudative polymorphous paraneoplastic vitelliform maculopathy (AEPPVM) following diagnosis and treatment of metastatic melanoma. METHODS Case report of a 47-year-old male with unknown primary metastatic melanoma and AEPPVM monitored before and during melanoma treatment using clinical exam, retinal imaging, and electroretinograms (ERG). Genetic testing and autoantibody panels were performed. RESULTS He presented within a month of metastatic melanoma diagnosis with numerous bilateral vitelliform lesions in the posterior pole, consistent with AEPPVM. Metastatic disease was treated with immunotherapy, radiosurgery, and radiation over 48 months. Maculopathy and metastatic disease improved and worsened in parallel. Genetic testing was negative for bestrophin-1. An autoantibody panel was positive for anti-recoverin and transducin-α. CONCLUSION AEPPVM is an uncommon paraneoplastic retinopathy found in patients with metastatic malignancy. To our knowledge, this is the first report demonstrating a temporal association between metastatic disease activity and quantifiable changes in retinal imaging over a 4-year period.
Collapse
Affiliation(s)
- Claire M Mueller
- Department of Ophthalmology, Oregon Health & Science University Casey Eye Institute, Portland, OR, USA
| | - Sara L Hojjatie
- Department of Hematology and Oncology, Emory University School of Medicine, Atlanta, GA, USA
| | - David H Lawson
- Emory University School of Medicine, Professor of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Nieraj Jain
- Emory University School of Medicine, Assistant Professor of Ophthalmology, Section of Vitreoretinal Surgery and Diseases, Atlanta, GA, USA
| | | | - Mohammad K Khan
- Emory University School of Medicine, Associate Professor of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Melinda L Yushak
- Emory University School of Medicine, Assistant Professor of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Ghazala A Datoo O'Keefe
- Emory University School of Medicine, Assistant Professor of Ophthalmology, Section of Vitreoretinal Surgery and Diseases, Section of Uveitis and Vasculitis, Atlanta, GA, USA
| |
Collapse
|
11
|
Gao J, Panse K, Foster CS, Anesi SD. Paraneoplastic acute exudative polymorphous vitelliform maculopathy improved with intravitreal methotrexate. Am J Ophthalmol Case Rep 2020; 20:100930. [PMID: 33005818 PMCID: PMC7509776 DOI: 10.1016/j.ajoc.2020.100930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 08/05/2020] [Accepted: 09/12/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose To describe a case of acute exudative polymorphous vitelliform maculopathy (AEPVM) treated with intravitreal methotrexate. Observations A 58-year-old man with a history of metastatic melanoma developed paraneoplastic acute exudative polymorphous vitelliform maculopathy, refractory to oral prednisone, intravitreal bevacizumab and intravitreal preservative-free triamcinolone. Improvement in vision and resolution of subfoveal fluid was later seen after intravitreal methotrexate therapy. Conclusions and Importance AEPVM is a rare and poorly understood retinal disorder that may be idiopathic or may manifest in patients with malignancies. The pathogenic process is thought to be an attack directed against the retinal pigment epithelium (RPE) and photoreceptors. Intravitreal methotrexate may provide benefit when treating AEPVM, especially when trials of steroids and anti-VEGF medications have failed.
Collapse
Affiliation(s)
- Jie Gao
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States
| | - Ketaki Panse
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States
| | - C Stephen Foster
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States.,Harvard Medical School, United States
| | - Stephen D Anesi
- Massachusetts Eye Research and Surgery Institution, United States.,Ocular Immunology and Uveitis Foundation, United States
| |
Collapse
|
12
|
Idiopathic Acute Exudative Polymorphous Vitelliform Maculopathy: Insight into Imaging Features and Outcomes. Case Rep Ophthalmol Med 2020; 2020:7254038. [PMID: 32082665 PMCID: PMC7008265 DOI: 10.1155/2020/7254038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/30/2019] [Accepted: 01/04/2020] [Indexed: 11/17/2022] Open
Abstract
The authors describe imagiological findings in idiopathic exudative polymorphous vitelliform maculopathy. A 41-year-old woman complained of bilateral blurry vision. Best-corrected visual acuity was 20/20 bilaterally. Bilateral small serous neurosensory detachments in the fovea were seen at fundoscopy and confirmed by spectral-domain optical coherence tomography. Fluorescein angiography was unremarkable. Indocyanine green angiography presented discrete hyperfluorescent spots on the posterior pole. Later, more bleb-like lesions with a vitelliform appearance and hyperautofluorescent on blue fundus autofluorescence were detected. One year later, a complete resolution of the fluid was observed. To conclude, multimodal evaluation of patients with idiopathic exudative polymorphous vitelliform maculopathy is essential for the correct diagnosis of this disease.
Collapse
|
13
|
Touhami S, Audo I, Terrada C, Gaudric A, LeHoang P, Touitou V, Bodaghi B. Neoplasia and intraocular inflammation: From masquerade syndromes to immunotherapy-induced uveitis. Prog Retin Eye Res 2019; 72:100761. [DOI: 10.1016/j.preteyeres.2019.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 04/16/2019] [Accepted: 05/01/2019] [Indexed: 12/18/2022]
|
14
|
MULTIMODAL IMAGING OF ACUTE EXUDATIVE POLYMORPHOUS VITELLIFORM MACULOPATHY WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND ADAPTIVE OPTICS SCANNING LASER OPHTHALMOSCOPY. Retin Cases Brief Rep 2019; 13:195-198. [PMID: 28520626 DOI: 10.1097/icb.0000000000000591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
PURPOSE To report a case of acute exudative polymorphous vitelliform maculopathy including the findings of optical coherence tomography angiography and adaptive optics scanning laser ophthalmoscopy. METHODS Findings on clinical examination, color fundus photography, spectral-domain optical coherence tomography, infrared reflectance, autofluorescence, optical coherence tomography angiography, and adaptive optics scanning laser ophthalmoscopy. RESULTS A 54-year-old white man with no significant medical history and history of smoking presented with bilateral multiple serous and vitelliform detachments consistent with acute exudative polymorphous vitelliform maculopathy. Extensive infectious, inflammatory, and malignancy workup was negative. Spectral-domain optical coherence tomography showed thickened, hyperreflective ellipsoid zone, subretinal fluid, and focal as well as diffuse subretinal hyperreflective material corresponding to the vitelliform lesions. Optical coherence tomography angiography showed normal retinal and choroidal vasculature, whereas adaptive optics scanning laser ophthalmoscopy showed circular focal "target" lesions at the level of the photoreceptors in the area of foveal detachment. CONCLUSION Multimodal imaging is valuable in evaluating patients with acute exudative polymorphous vitelliform maculopathy.
Collapse
|
15
|
ACUTE EXUDATIVE PARANEOPLASTIC POLYMORPHOUS VITELLIFORM MACULOPATHY DURING VEMURAFENIB AND PEMBROLIZUMAB TREATMENT FOR METASTATIC MELANOMA. Retin Cases Brief Rep 2019; 13:103-107. [PMID: 28614138 DOI: 10.1097/icb.0000000000000604] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To describe a patient with BRAF mutation-positive cutaneous melanoma who developed acute exudative polymorphous vitelliform maculopathy during vemurafenib and pembrolizumab treatment for metastatic melanoma. METHODS Retrospective case report documented with wide-field fundus imaging, spectral domain optical coherence tomography, and fundus autofluorescence imaging. RESULTS A 55-year-old woman with bilateral ductal breast carcinoma and BRAF mutation-positive metastatic cutaneous melanoma complained of bilateral blurred vision within 5 days of starting vemurafenib (BRAF inhibitor). She had been on pembrolizumab (program death receptor antibody) and intermittently on dabrafenib (BRAF inhibitor) and trametinib (MEK inhibitor), and had a normal ophthalmologic examination. On presentation three weeks after the introduction of vemurafenib, her visual acuity had declined to 20/40 in both eyes. Her examination showed diffuse elevation of the fovea with multifocal yellow-white, crescent-shaped subretinal deposits within the macula of both eyes and bilateral neurosensory retinal detachments by spectral domain optical coherence tomography. Discontinuation of vemurafenib and introduction of difluprednate and dorzolamide led to a gradual resolution (over four months) of the neurosensory detachments with recovery of vision. CONCLUSION This case report suggests that acute exudative polymorphous vitelliform maculopathy may be directly associated with the use of BRAF inhibitors as treatment for metastatic cutaneous melanoma, or indirectly by triggering autoimmune-paraneoplastic processes. Future identification of similar associations is required to unequivocally link vemurafenib and/or pembrolizumab to acute exudative polymorphous vitelliform maculopathy in metastatic melanoma.
Collapse
|
16
|
Bussat A, Langner-Lemercier S, Salmon A, Mouriaux F. Paraneoplastic syndromes in ophthalmology. J Fr Ophtalmol 2018; 41:e181-e185. [PMID: 29784239 DOI: 10.1016/j.jfo.2018.03.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 03/12/2018] [Accepted: 03/14/2018] [Indexed: 10/16/2022]
Abstract
Paraneoplastic syndromes involving the visual system are a heterogeneous group of disorders occurring in the setting of systemic malignancy. They are unrelated to local tumor invasion or metastasis and unexplained by nutritional, metabolic, infectious or iatrogenic causes. The presence of antibodies may aid in the diagnosis of a paraneoplastic syndrome, although this is not an absolute requirement. Chorioretinal involvement is seen in CAR (cancer-associated retinopathy) syndrome, MAR (melanoma-associated retinopathy) syndrome, paraneoplastic vitelliform maculopathy, and bilateral diffuse uveal melanocytic proliferation. Paraneoplastic neurological syndromes with ophthalmologic involvement include optic neuropathy, opsoclonus-myoclonus, Eaton-Lambert myasthenic syndrome, paraneoplastic cerebellar degeneration (PCD) and rhombencephalitis.
Collapse
Affiliation(s)
- A Bussat
- Ophthalmology Service, CHU de Rennes, 35033 Rennes cedex, France
| | | | - A Salmon
- Neurology Service, CHU de Rennes, 35033 Rennes cedex, France
| | - F Mouriaux
- Ophthalmology Service, CHU de Rennes, 35033 Rennes cedex, France.
| |
Collapse
|
17
|
PARANEOPLASTIC VITELLIFORM MACULOPATHY ASSOCIATED WITH METASTATIC MELANOMA. Retin Cases Brief Rep 2017; 12 Suppl 1:S102-S104. [PMID: 29176532 DOI: 10.1097/icb.0000000000000660] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE To report a case of paraneoplastic vitelliform maculopathy in a patient with metastatic melanoma of unknown primary site. METHODS Case report. Main outcome measures include funduscopic examination, fluorescein angiography, fundus autofluorescence, and spectral domain optical coherence tomography. RESULTS A 44-year-old man with a known history of metastatic melanoma was referred for ophthalmic evaluation because of bilateral vision loss. Funduscopic examination was remarkable for vitelliform maculopathy that was confirmed with fundus autofluorescence and spectral domain optical coherence tomography. CONCLUSION We describe a rare case of paraneoplastic vitelliform maculopathy. There are many etiologies of acquired vitelliform retinal lesions in the retina. Multimodal retinal imaging, including fundus autofluorescence and spectral domain optical coherence tomography, can be best used to identify these lesions. A history of systemic metastatic melanoma should be ruled out in patients with vitelliform maculopathy.
Collapse
|
18
|
Exudative retinal detachment. Surv Ophthalmol 2017; 62:723-769. [DOI: 10.1016/j.survophthal.2017.05.001] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 05/01/2017] [Accepted: 05/05/2017] [Indexed: 12/11/2022]
|
19
|
Gündüz K, Çöndü G, Shields CL. Acute Exudative Polymorphous Paraneoplastic Vitelliform Maculopathy Managed With Intravitreal Aflibercept. Ophthalmic Surg Lasers Imaging Retina 2017; 48:844-850. [DOI: 10.3928/23258160-20170928-11] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/01/2017] [Indexed: 11/20/2022]
|
20
|
Nagiel A, Rootman DB, McCannel TA. PARANEOPLASTIC VITELLIFORM MACULOPATHY IN THE SETTING OF CHOROIDAL MELANOMA: EVOLUTION OVER ONE YEAR. Retin Cases Brief Rep 2017; 11 Suppl 1:S7-S10. [PMID: 27533643 DOI: 10.1097/icb.0000000000000383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND To illustrate the evolution of paraneoplastic vitelliform maculopathy over one year using optical coherence tomography. METHODS Observational case report. RESULTS A 65-year-old man with a history of ocular melanocytosis and choroidal melanoma of the left eye treated with plaque brachytherapy 3 years prior returned for his yearly follow-up visit. The visual acuity in the right eye was 20/20. Subtle thickening of the interdigitation zone layer was noted on optical coherence tomography. Over the following year, multifocal vitelliform detachments developed with progressive enlargement and coalescence of the lesions. Paraneoplastic vitelliform maculopathy developed in the fellow eye of a patient with local recurrence of previously treated choroidal melanoma. CONCLUSION Paraneoplastic vitelliform maculopathy may develop in the fellow eye of a patient with local recurrence of their previously treated choroidal melanoma with no clinical evidence of systemic metastasis.
Collapse
Affiliation(s)
- Aaron Nagiel
- *Retina Division, Stein Eye Institute, Los Angeles, California; †Orbital and Ophthalmic Plastic Surgery Division, Stein Eye Institute, Los Angeles, California; and ‡Doheny Eye Institute, Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | | | | |
Collapse
|
21
|
Gangaputra S, Kodati S, Kim M, Aranow M, Sen HN. Multimodal Imaging in Masquerade Syndromes. Ocul Immunol Inflamm 2017; 25:160-168. [PMID: 28414612 DOI: 10.1080/09273948.2017.1296165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Masquerade syndromes present to uveitis clinics due to the appearance of inflammatory signs and chronic symptoms that are not responsive to conventional treatment. They are frequently misdiagnosed and treated as refractory inflammatory conditions, which delays appropriate diagnosis and management. This review of literature focuses on the commonly encountered masquerade syndromes and discusses the role of multimodal imaging in addressing these complex clinical presentations. We review the conventional imaging techniques for these patients and discuss emerging technological advances that may help in establishing a diagnosis. We present cases highlighting the utility of multimodal imaging in identifying the etiology.
Collapse
Affiliation(s)
- Sapna Gangaputra
- a Lab of Immunology , National Eye Institute, National Institutes of Health , Bethesda , Maryland , USA
| | - Shilpa Kodati
- a Lab of Immunology , National Eye Institute, National Institutes of Health , Bethesda , Maryland , USA
| | - Meredith Kim
- a Lab of Immunology , National Eye Institute, National Institutes of Health , Bethesda , Maryland , USA
| | - Marybeth Aranow
- b Wilmer Eye Institute , Johns Hopkins School of Medicine , Baltimore , Maryland , USA
| | - H Nida Sen
- a Lab of Immunology , National Eye Institute, National Institutes of Health , Bethesda , Maryland , USA
| |
Collapse
|
22
|
Li DQ, Golding J, Glittenberg C, Choudhry N. Multimodal Imaging Features in Acute Exudative Paraneoplastic Polymorphous Vitelliform Maculopathy. Ophthalmic Surg Lasers Imaging Retina 2016; 47:1143-1146. [DOI: 10.3928/23258160-20161130-09] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 09/16/2016] [Indexed: 11/20/2022]
|
23
|
Yung M, Klufas MA, Sarraf D. Clinical applications of fundus autofluorescence in retinal disease. Int J Retina Vitreous 2016; 2:12. [PMID: 27847630 PMCID: PMC5088473 DOI: 10.1186/s40942-016-0035-x] [Citation(s) in RCA: 116] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 02/15/2016] [Indexed: 12/30/2022] Open
Abstract
Fundus autofluorescence (FAF) is a non-invasive retinal imaging modality used in clinical practice to provide a density map of lipofuscin, the predominant ocular fluorophore, in the retinal pigment epithelium. Multiple commercially available imaging systems, including the fundus camera, the confocal scanning laser ophthalmoscope, and the ultra-widefield imaging device, are available to the clinician. Each offers unique advantages for evaluating various retinal diseases. The clinical applications of FAF continue to expand. It is now an essential tool for evaluating age related macular degeneration, macular dystrophies, retinitis pigmentosa, white dot syndromes, retinal drug toxicities, and various other retinal disorders. FAF may detect abnormalities beyond those detected on funduscopic exam, fluorescein angiography, or optical coherence tomography, and can be used to elucidate disease pathogenesis, form genotype-phenotype correlations, diagnose and monitor disease, and evaluate novel therapies. Given its ease of use, non-invasive nature, and value in characterizing retinal disease, FAF enjoys increasing clinical relevance. This review summarizes common ocular fluorophores, imaging modalities, and FAF findings for a wide spectrum of retinal disorders.
Collapse
Affiliation(s)
- Madeline Yung
- Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, CA 90095 USA
| | - Michael A. Klufas
- Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, CA 90095 USA
| | - David Sarraf
- Stein Eye Institute, David Geffen School of Medicine at University of California, Los Angeles, CA 90095 USA
- Greater Los Angeles VA Healthcare Center, Los Angeles, CA 90024 USA
| |
Collapse
|
24
|
Lincoff N, Nadeem M, Younus Z, Thirkill CE. Exudative Polymorphous Vitelliform Retinopathy: Importance of Early Recognition of the Condition in Patients with Metastatic Melanoma. Ophthalmol Ther 2016; 5:121-7. [PMID: 26892474 PMCID: PMC4909671 DOI: 10.1007/s40123-016-0044-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Indexed: 11/24/2022] Open
Abstract
Introduction Because of the advent of monoclonal antibodies in the treatment of metastatic melanoma, patients with this disease are surviving longer.
Early recognition of the disease has therefore become even more important. Case report We present a patient with vitelliform maculopathy, a paraneoplastic retinal maculopathy that is under-recognized. Clinically the retinal findings of serous detachments and pigmentary macular changes are remarkable, while at the same time these patients have surprisingly very few symptoms. This is in contrast to patients who develop melanoma associated retinopathy (MAR) who are very symptomatic early in the disease, but with more subtle retinal findings. Conclusion Monoclonal antibody treatment is changing the survival rates in metastatic disease making early diagnosis even more important. Exudative polymorphous vitelliform maculopathy (EPVM) needs to be recognized early to avoid delay in diagnosis of metastatic disease.
Collapse
Affiliation(s)
- Norah Lincoff
- Buffalo General Medical Center, State University of New York, Buffalo, 100 High Street, Buffalo, NY, 14203, USA.
| | - Muhammad Nadeem
- Buffalo General Medical Center, State University of New York, Buffalo, 100 High Street, Buffalo, NY, 14203, USA
| | - Zilfah Younus
- Buffalo General Medical Center, State University of New York, Buffalo, 100 High Street, Buffalo, NY, 14203, USA
| | - Charles E Thirkill
- Ocular Immunology Lab 1220, University of California, Davis, U. C. Davis, Davis, CA, USA
| |
Collapse
|
25
|
Adult-onset foveomacular vitelliform dystrophy: A fresh perspective. Prog Retin Eye Res 2015; 47:64-85. [DOI: 10.1016/j.preteyeres.2015.02.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 02/01/2015] [Accepted: 02/04/2015] [Indexed: 01/06/2023]
|
26
|
Acute exudative polymorphous vitelliform maculopathy in a young man: a case report. Retin Cases Brief Rep 2015; 8:200-4. [PMID: 25372438 DOI: 10.1097/icb.0000000000000042] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe ocular findings consistent with acute exudative polymorphous vitelliform maculopathy in a healthy 34-year-old man. METHODS Observational case report of a patient presenting with blurred vision in the left eye greater than the right eye. RESULTS Funduscopic examination and fluorescein angiography were consistent with acute exudative vitelliform maculopathy, a rare exudative macular disorder. Five months after presentation, the patient was diagnosed with metastatic melanoma. CONCLUSION A case is reported in a young man with no diagnosis of primary neoplasm at the time of presentation, and no other symptoms overall, who was later diagnosed with a metastatic malignancy.
Collapse
|
27
|
Dalvin LA, Johnson AA, Pulido JS, Dhaliwal R, Marmorstein AD. Nonantibestrophin Anti-RPE Antibodies in Paraneoplastic Exudative Polymorphous Vitelliform Maculopathy. Transl Vis Sci Technol 2015; 4:2. [PMID: 26046004 DOI: 10.1167/tvst.4.3.2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 04/02/2015] [Indexed: 12/11/2022] Open
Abstract
PURPOSE A previous report demonstrated antibodies to bestrophin in paraneoplastic exudative polymorphous vitelliform maculopathy (PEPVM). Other cases demonstrated antibodies to different proteins in the retinal pigment epithelium (RPE). In this report, serum was analyzed to determine whether a patient with PEPVM and a reduced Arden ratio had developed autoantibodies to human Bestrophin-1 (Best1). METHODS Human embryonic kidney 293 cells (HEK293) were transfected with Best1 and stained with an antibody specific to Best1 (E6-6), or patient serum. Staining patterns were compared with those of untransfected cells stained with E6-6, patient serum, control serum, or secondary antibody alone. Western blots were performed using lysed RPE and stained with E6-6, patient serum, control serum, or secondary antibody alone. RESULTS Immunofluorescence staining of HEK-293 cells or HEK-293 cells expressing Best1 did not differ between patient and control sera or show a staining pattern consistent with recognition of Best1. Immunoblotting of human RPE lysate with patient serum did not identify Best1 (68 kDa) but did recognize a band at approximately 48 kDa that was absent in blots using control serum. CONCLUSIONS To our knowledge, this is the first report of PEPVM with an autoantibody to an approximately 48-kDa RPE protein, but previous reports have demonstrated autoantibodies to other RPE proteins, suggesting that autoantibody formation is an important component of PEPVM. TRANSLATIONAL RELEVANCE This research emphasizes the role that autoantibodies play in PEPVM. The fact that different autoantibodies appear to cause similar patterns demonstrates the heterogeneity of causes of vitelliform lesions.
Collapse
Affiliation(s)
| | | | - Jose S Pulido
- Department of Ophthalmology Mayo Clinic, Rochester, MN, USA ; Molecular Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | |
Collapse
|
28
|
Pang CE, Shields CL, Jumper JM, Yannuzzi LA. Paraneoplastic cloudy vitelliform submaculopathy in primary vitreoretinal lymphoma. Am J Ophthalmol 2014; 158:1253-1261.e2. [PMID: 25174893 DOI: 10.1016/j.ajo.2014.08.031] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 08/24/2014] [Accepted: 08/25/2014] [Indexed: 12/16/2022]
Abstract
PURPOSE To describe the nature and evolution of paraneoplastic cloudy vitelliform submaculopathy in patients with primary vitreoretinal lymphoma and propose a mechanism for its development and course. DESIGN Retrospective, observational case series. METHODS Three patients presenting with unilateral cloudy vitelliform submaculopathy based on clinical examination, fundus autofluorescence, fluorescein angiography, and spectral-domain optical coherence tomography (SD OCT) imaging and ultimately diagnosed with primary vitreoretinal lymphoma and/or primary central nervous system lymphoma were analyzed. RESULTS In all 3 patients, cloudy vitelliform submaculopathy appeared with hazy indistinct yellow subretinal material resembling the vitelliform lesions found in acute exudative paraneoplastic polymorphous vitelliform maculopathy, although with less distinct appearance and without intense hyper-autofluorescence. In all 3 patients, cloudy vitelliform submaculopathy was transient, showed spontaneous regression within 3 months, and preceded the diagnosis of lymphoma, suggestive of a paraneoplastic process. The diagnosis of primary vitreoretinal lymphoma and/or primary central nervous system lymphoma was made within 6 months with classic features of new intraretinal or sub-retinal pigment epithelium infiltration of lymphoma in the peripheral retina (n = 2) and hyperintense lesions on brain magnetic resonance imaging (n = 2). With SD OCT imaging, the cloudy vitelliform subretinal lesions appeared as hyperreflective debris above the retinal pigment epithelium band in all 3 eyes, and were associated with an irregularly thickened and rippled retinal pigment epithelium band in 2 eyes. Resolution of the cloudy submacular lesions resulted in outer retinal atrophic changes in all 3 eyes. CONCLUSION Paraneoplastic cloudy vitelliform submaculopathy, a form of lymphoma-associated retinopathy, can precede the diagnosis of primary vitreoretinal lymphoma or primary central nervous system lymphoma and can regress spontaneously, leaving outer retinal abnormalities.
Collapse
Affiliation(s)
- Claudine E Pang
- Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York.
| | - Carol L Shields
- Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
| | | | - Lawrence A Yannuzzi
- Vitreous Retina Macula Consultants of New York, New York, New York; LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear and Throat Hospital, New York, New York; Department of Ophthalmology, New York University, New York, New York
| |
Collapse
|
29
|
Grajewski RS, Schuler-Thurner B, Mauch C, Kreuzberg N, Koch KR, Bergua A, Cursiefen C, Heindl LM. Ocular diseases in metastatic cutaneous melanoma: review of 108 consecutive patients in two German tertiary centers. Graefes Arch Clin Exp Ophthalmol 2014; 252:679-85. [DOI: 10.1007/s00417-013-2563-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 12/06/2013] [Accepted: 12/31/2013] [Indexed: 12/01/2022] Open
|
30
|
Intravitreal Dexamethasone Implant for Acute Exudative Polymorphous Vitelliform Maculopathy. Eur J Ophthalmol 2014; 24:803-7. [DOI: 10.5301/ejo.5000477] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2014] [Indexed: 11/20/2022]
Abstract
Purpose Acute exudative polymorphous vitelliform maculopathy is a rare retinal disease characterized by bilateral serous macular detachment and subretinal accumulation of yellowish deposits resembling Best dystrophy lesions. Corticosteroid systemic therapy has been used empirically in the attempt to treat this retinal disorder with mixed results. Thus, the benefit of corticosteroid remains undetermined. To our knowledge, we report the first case of acute exudative polymorphous vitelliform maculopathy (AEPVM) treated in one eye with intravitreal dexamethasone implant (Ozurdex; Allergan, Inc., Irvine, California, USA). Methods A 28-year-old man with AEPVM underwent intravitreal dexamethasone implantation in the left eye. Results Compared with the fellow eye, intravitreal dexamethasone implant did not significantly modify the clinical course of the disease. No implant-related complication was experienced during follow-up. Conclusions The lack of response to intravitreal dexamethasone seems to suggest that corticosteroids may be ineffective for the treatment of AEPVM.
Collapse
|
31
|
Rahimy E, Sarraf D. Paraneoplastic and non-paraneoplastic retinopathy and optic neuropathy: Evaluation and management. Surv Ophthalmol 2013; 58:430-58. [DOI: 10.1016/j.survophthal.2012.09.001] [Citation(s) in RCA: 138] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Revised: 08/27/2012] [Accepted: 12/04/2012] [Indexed: 12/29/2022]
|
32
|
Singh RS, Tran LH, Kim JE. Acute Exudative Polymorphous Vitelliform Maculopathy in a Patient With Lyme Disease. Ophthalmic Surg Lasers Imaging Retina 2013; 44:493-6. [DOI: 10.3928/23258160-20130909-14] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 07/19/2013] [Indexed: 11/20/2022]
|