Relatamos dois casos de baixa visual após cirurgia bem sucedida de catarata, associada a descolamento drusenóide do epitélio pigmentar da retina (DPED) sem achados de neovascularização de coroide a tomografia de coerência óptica OCT (CNV silente ao OCT) e com exames angiográficos sugestivos de neovascularização da coroide (CNV), nos quais melhoras anatômicas e funcionais foram obtidas com aplicações intravítreas de anti-VEGF.

Descritores:
Neovascularização da coroide; Degeneração macular; Tomografia de coerência óptica; Injeções intravítreas; Angiofluoresceinografia; Humanos; Relatos de casos

Autoria

Felipe Placeres Borges Corresponding author: Felipe Placeres Borges. Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Avenida Bandeirantes, 3.900 - Ribeirão Preto, SP - 14049-900 - Brazil. E-mail: borges.fp@gmail.com

Department of Ophthalmology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.Universidade de São PauloBrazilRibeirão Preto, SP, BrazilDepartment of Ophthalmology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

Rubens Camargo Siqueira

Ingrid Ursula Scott

Departments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.Penn State College of MedicineUSAHershey, PA, USADepartments of Ophthalmology and Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.

José Augusto Cardillo

Rodrigo Jorge

Corresponding author: Felipe Placeres Borges. Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Avenida Bandeirantes, 3.900 - Ribeirão Preto, SP - 14049-900 - Brazil. E-mail: borges.fp@gmail.com

Disclosure of potential conflicts of interest: None of the authors have any potential conflict of interest to disclose.

SCIMAGO INSTITUTIONS RANKINGS

Figuras

Figuras (2)

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Figure 1
(Case 1): A) Early phase pre-treatment. Left: fluorescein angiography (FA) with discrete foci of parafoveal hypofluorescence as a result of drusen blockage. Right: indocyanine green angiography (ICGA) demonstrates a hyperfluorescent spot in the foveal region (*). B) Late phase pre-treatment. Left: FA shows staining of the drusen. Right: ICGA demonstrates increased hyperfluorescence and better delineation of the foveal lesion (*). C) Pre-treatment optical coherence tomography (OCT) demonstrates an epiretinal membrane and a double-humped PED. D) Early phase post-treatment. Left: FA shows early hyperfluorescence from the drusen. Right: ICGA no longer shows the hyperfluorescent lesion. E) Late phase post-treatment. Left: FA shows staining of the drusen. Right: ICGA demonstrates absence of the hot spot visualized on the pre-treatment ICGA. F) Post-treatment OCT shows that the PED has flattened.

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Figure 2
(Case 2): A) Early phase pre-treatment. Left: FA shows a small round hyperfluorescent lesion inferonasal to the fovea. Right: ICGA demonstrates a hypofluorescent foveal dot in the PED. B) Late phase pre-treatment. Left: FA shows an increased area of fluorescein leakage from the lesion. Right: ICGA demonstrates no late changes. C) Pre-treatment multimodal FA/OCT. Of note, the hyperfluorescent dot observed on FA does not correspond to the foveal PED. D) Early phase post-treatment. Left: FA shows absence of the hyperfluorescent dot seen on the pre-treatment FA. Right: ICGA demonstrates transmission hyperfluorescence. E) Late phase post-treatment. Left: No late hyperfluorescent dot is observed on FA. Right: ICGA demonstrates transmission hyperfluorescence. F) Post-treatment FA/OCT demonstrates involution of the PED with atrophy of the outer retina.

Figure 1 (Case 1): A) Early phase pre-treatment. Left: fluorescein angiography (FA) with discrete foci of parafoveal hypofluorescence as a result of drusen blockage. Right: indocyanine green angiography (ICGA) demonstrates a hyperfluorescent spot in the foveal region (). B) Late phase pre-treatment. Left: FA shows staining of the drusen. Right: ICGA demonstrates increased hyperfluorescence and better delineation of the foveal lesion (). C) Pre-treatment optical coherence tomography (OCT) demonstrates an epiretinal membrane and a double-humped PED. D) Early phase post-treatment. Left: FA shows early hyperfluorescence from the drusen. Right: ICGA no longer shows the hyperfluorescent lesion. E) Late phase post-treatment. Left: FA shows staining of the drusen. Right: ICGA demonstrates absence of the hot spot visualized on the pre-treatment ICGA. F) Post-treatment OCT shows that the PED has flattened.

Figure 2 (Case 2): A) Early phase pre-treatment. Left: FA shows a small round hyperfluorescent lesion inferonasal to the fovea. Right: ICGA demonstrates a hypofluorescent foveal dot in the PED. B) Late phase pre-treatment. Left: FA shows an increased area of fluorescein leakage from the lesion. Right: ICGA demonstrates no late changes. C) Pre-treatment multimodal FA/OCT. Of note, the hyperfluorescent dot observed on FA does not correspond to the foveal PED. D) Early phase post-treatment. Left: FA shows absence of the hyperfluorescent dot seen on the pre-treatment FA. Right: ICGA demonstrates transmission hyperfluorescence. E) Late phase post-treatment. Left: No late hyperfluorescent dot is observed on FA. Right: ICGA demonstrates transmission hyperfluorescence. F) Post-treatment FA/OCT demonstrates involution of the PED with atrophy of the outer retina.

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[1] Corresponding author: Felipe Placeres Borges. Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto. Avenida Bandeirantes, 3.900 - Ribeirão Preto, SP - 14049-900 - Brazil. E-mail: borges.fp@gmail.com