First Author: A.El Sayed EGYPT
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The purpose of this study was to determine if intravitreal Aflibercept (IVA) would be effective in the treatment of a macular edema (ME) caused by Leber’s miliary aneurysm (LMA); this was attempted together with peripheral laser photocoagulation for the abnormal vessels & microanuerysms.
The study was conducted on the patients visiting the retina subspeciality clinic at the faculty of medicine, Alexandria Unversity, Egypt.
A retrospective interventional non-comparative case series included 5 eyes of patients with unilateral gradual diminution of vision, clinical diagnosis of abnormal peripheral vasculopathy. Fluorescein angiography revealed many aneurysms with leakage temporal, mid-peripheral retina, and near the macula. Optical coherence tomography (OCT) showed a moderate to marked cystoid ME and subretinal fluid. Based on these findings, we diagnosed the patient with LMA. We performed laser photocoagulation of the aneurysms, except near the fovea. Three to 5 IVA was needed to dry off the macula. Serial colour fundus photography & OCT were performed to measure treatment efficacy.
After three to five Aflibercept injections, all five patients had subretinal fluid completely reabsorbed. Included patients had one session of ablative laser procedure for diseased vessels. One patient needed supplemental laser therapy three months from the first session. One patient had recurrent subretinal fluid three months later, for which one aflibercept injection was enough to dry off the macula again. Improved visual acuity was noted in all cases. No ocular or systemic complications related to IVA usage were noted during the entire course of follow-up ( average 5.5 months).
Intravitreal Aflibercept with peripheral laser ablation appears to be a well-tolerated treatment for patients with LMA which has the potential to improve final visual acuity.