Implante de liberacao lenta de dexametasona para retinopatia associada ao cancer

Este relato de caso tem como objetivo mostrar os resultados anatômicos e funcionais de um paciente com diagnóstico de retinopatia associada ao câncer tratado com implante de liberação controlada de dexametasona (Ozurdex®). Os resultados anatômicos foram avaliados por SD-OCT e os resultados funcionais por medida de acuidade visual, microperimetria e eletrorretinograma multifocal. O período de acompanhamento foi de um ano.

Descritores:
Retinopatia; Dexametasona; Síndromes paraneoplásicas oculares; Eletroretinografia

Autoria

Leandro J. Chaves

Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, BrazilUniversidade de São PauloBrazilRibeirão Preto, SP, BrazilDepartment of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil

https://orcid.org/0000-0001-6865-4949

Marina L. de Albuquerque

https://orcid.org/0000-0002-6931-4273

Amanda Schnorr

Francyne Cyrino

https://orcid.org/0000-0002-1892-6210

Maria Lúcia Habib

https://orcid.org/0000-0001-5331-903X

André Messias

https://orcid.org/0000-0002-5328-9608

Zelia M. Correa

Ocular Oncology Service, Bascom Palmer Eye Institute and Sylvester Cancer Center, University of Miami, Miami, FL, USAUniversity of MiamiUSAMiami, FL, USAOcular Oncology Service, Bascom Palmer Eye Institute and Sylvester Cancer Center, University of Miami, Miami, FL, USA

https://orcid.org/0000-0003-2946-3757

Rodrigo Jorge Corresponding author: Rodrigo Jorge. E-mail: retinausp@gmail.br

https://orcid.org/0000-0002-2652-0720

Corresponding author: Rodrigo Jorge. E-mail: retinausp@gmail.br

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

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Figure 1.
Baseline multimodal assessment. (A, B) An unremarkable color fundus retinography finding. (C, D) Spectral domain optical coherence tomography image showing the granular aspects of the inner and outer segment layers and ellipsoid zone. (E, F) Baseline microperimetry sensitivity map is abnormal in both eyes. (G, H) Multifocal electroretinogram trace array showing an abnormal asymmetrical reduction in central response in both eyes.

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Figure 2.
Clinical outcome 30 days after insertion of the controlled-release dexamethasone implant in the left eye. (A) Spectral domain optical coherence tomography (OCT) image showing no changes in the right eye. (B) Spectral domain OCT image showing partial recovery of the inner and outer segment layers and ellipsoid zone of the left eye. (C, D) Microperimetry sensitivity maps showing abnormal macular integrity especially in the left eye, although it is an improvement from that at baseline. (E, F) Abnormal multifocal electroretinogram trace array in both eyes, showing an asymmetrical reduction in central response.

Figure 1. Baseline multimodal assessment. (A, B) An unremarkable color fundus retinography finding. (C, D) Spectral domain optical coherence tomography image showing the granular aspects of the inner and outer segment layers and ellipsoid zone. (E, F) Baseline microperimetry sensitivity map is abnormal in both eyes. (G, H) Multifocal electroretinogram trace array showing an abnormal asymmetrical reduction in central response in both eyes.

Figure 2. Clinical outcome 30 days after insertion of the controlled-release dexamethasone implant in the left eye. (A) Spectral domain optical coherence tomography (OCT) image showing no changes in the right eye. (B) Spectral domain OCT image showing partial recovery of the inner and outer segment layers and ellipsoid zone of the left eye. (C, D) Microperimetry sensitivity maps showing abnormal macular integrity especially in the left eye, although it is an improvement from that at baseline. (E, F) Abnormal multifocal electroretinogram trace array in both eyes, showing an asymmetrical reduction in central response.

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Implante de liberacao lenta de dexametasona para retinopatia associada ao cancer

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[1] Corresponding author: Rodrigo Jorge. E-mail: retinausp@gmail.br