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Case Rep Ophthalmol Med
2014 Jan 01;2014:682583. doi: 10.1155/2014/682583.
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Intravitreal Ranibizumab for Stage IV Proliferative Sickle Cell Retinopathy: A First Case Report.
Mitropoulos PG
,
Chatziralli IP
,
Parikakis EA
,
Peponis VG
,
Amariotakis GA
,
Moschos MM
.
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Purpose. To present the case of a 27-year-old male patient with stage IV proliferative sickle cell retinopathy, treated with one intravitreal injection of ranibizumab, showing regression of the neovascularization and no recurrence at the 9-month follow-up. Methods. A 27-year-old male patient presented with blurred vision and floaters in the right eye since three days. His best corrected visual acuity was 6/18. Ophthalmological examination and fluorescein angiography revealed proliferative sickle cell retinopathy stage IV with vitreous hemorrhage and sea fan neovascularization, as well as ischemic areas at the temporal periphery. Results. The patient was treated with one intravitreal injection of ranibizumab, presenting improvement in the visual acuity from 6/18 to 6/6, resolution of vitreous hemorrhage, and regression of the neovascularization. Additionally, he underwent scatter laser photocoagulation at the ischemic areas. At the 9-month follow-up there was no recurrence, while no adverse effects were noticed. Conclusions. Intravitreal ranibizumab may be a useful adjunct to laser photocoagulation in the management of proliferative sickle cell retinopathy and may permit some patients to avoid pars plana vitrectomy for vitreous hemorrhage.
Figure 1. (a) Infrared fundus photo, showing vitreous hemorrhage in the right eye; (b, c) optical coherence tomography, showing no macular abnormalities; (d) infrared fundus photo, showing sea fan neovascularization at the temporal periphery; (e–g) fluorescein angiography, showing leakage from the neovascularization and ischemia in the periphery.
Figure 2. (a, b) Infrared fundus photo and optical coherence tomography in the left eye, totally normal; (c, d) fluorescein angiography, showing small ischemic areas at the temporal periphery of the left eye.
Figure 3. (a–d) Fluorescein angiography, showing improvement of vitreous hemorrhage and slight regression of neovascularization, but presence of ischemic areas, one week after intravitreal ranibizumab injection; (e–h) fluorescein angiography, showing total absorption of vitreous hemorrhage, regression of neovascularization and ischemia at the periphery one month after intravitreal ranibizumab injection; (i–l) fluorescein angiography, showing laser photocoagulation spots in the previous ischemic areas, no recurrence of vitreous hemorrhage, and regression of neovascularization compared to baseline.
Figure 4. (a, b) Infrared fundus photo of the right eye, showing no vitreous hemorrhage and presence of fibrotic tissue at the site of previous neovascularization, as well as presence of laser photocoagulation spots in the periphery; (c–e) fluorescein angiography, showing coverage of previous ischemic areas with scatter laser photocoagulation and improvement of sea fan neovascularization, with only slight leakage hyperfluorescence in the photocoagulated area.
Babalola,
Intravitreal bevacizumab (Avastin) associated with secondary hyphaema in a case of proliferative sickle cell retinopathy.
2010, Pubmed,
Echinobase
Babalola,
Intravitreal bevacizumab (Avastin) associated with secondary hyphaema in a case of proliferative sickle cell retinopathy.
2010,
Pubmed
,
Echinobase
Bonanomi,
Sickle cell retinopathy: diagnosis and treatment.
2013,
Pubmed
Brasileiro,
Macular and peripapillary spectral domain optical coherence tomography changes in sickle cell retinopathy.
2015,
Pubmed
Bunn,
Pathogenesis and treatment of sickle cell disease.
1997,
Pubmed
Castellanos,
Short-term outcome after intravitreal ranibizumab injections for the treatment of retinopathy of prematurity.
2013,
Pubmed
Chatziralli,
Branch retinal vein occlusion: treatment modalities: an update of the literature.
2014,
Pubmed
Dhoot,
Ranibizumab for age-related macular degeneration.
2012,
Pubmed
Elagouz,
Sickle cell disease and the eye: old and new concepts.
2010,
Pubmed
Fox,
Risk factors for proliferative sickle retinopathy.
1990,
Pubmed
Gaillard,
ranibizumab in the management of advanced Coats disease Stages 3B and 4: long-term outcomes.
2014,
Pubmed
Goldberg,
Classification and pathogenesis of proliferative sickle retinopathy.
1971,
Pubmed
Goldberg,
Retinal neovascularization in sickle cell retinopathy.
1977,
Pubmed
,
Echinobase
Goldberg,
Ophthalmologic manifestations of sickle cell thalassemia.
1971,
Pubmed
Lantry,
Ranibizumab, a mAb against VEGF-A for the potential treatment of age-related macular degeneration and other ocular complications.
2007,
Pubmed
Leveziel,
[Sickle-cell retinopathy: Retrospective study of 730 patients followed in a referral center].
2012,
Pubmed
Miller,
Vascular endothelial growth factor and ocular neovascularization.
1997,
Pubmed
Modell,
Global epidemiology of haemoglobin disorders and derived service indicators.
2008,
Pubmed
Shaikh,
Intravitreal bevacizumab (Avastin) for the treatment of proliferative sickle retinopathy.
2008,
Pubmed
Shweiki,
Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis.
1992,
Pubmed
Siqueira,
Intravitreal bevacizumab (Avastin) injection associated with regression of retinal neovascularization caused by sickle cell retinopathy.
2006,
Pubmed
Waisbourd,
Treatment of diabetic retinopathy with anti-VEGF drugs.
2011,
Pubmed
Wang,
Intravitreal anti-vascular endothelial growth factor for choroidal neovascularization secondary to pathologic myopia: systematic review and meta-analysis.
2013,
Pubmed
