First Author: T.Xirou GREECE
Co Author(s): O. Georgiadis G. Batsos V. Xirou E. Feretis S. Kabanarou 0 0 0 0 0 0 0 0 0
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To report a case of hypertensive retinopathy with bilateral retinal neovascularization treated with anti-VEGF intravitreal injection in one eye and panretinal photocoagulation (PRP) in the fellow eye.
Medical Retina Department. Ophthalmology Clinic, Hellenic Red-Cross Hospital
A 33-year-old male patient presented with gradual visual loss in both eyes for the last five months. At that time he was examined at a private hospital elsewhere and a colour fundus photography and fluorescein angiography (FFA) was performed. Idiopathic malignant systematic hypertension was diagnosed. He was put on systemic hypertensive treatment but no ophthalmic treatment was undertaken. There was no other relevant medical or family history. At presentation in our clinic five months later best corrected visual acuity (BCVA) was CF in the right eye and 8/10 in the left eye. Anterior segment examination was unremarkable for both eyes. Fundus examination showed abnormalities in both eyes compatible with hypertensive retinopathy and extensive areas of neovascularization. FFA revealed macular ischaemia mainly in the right eye, large areas of peripheral retinal ischaemia and retinal neovascularization with vascular leakage, mainly across the temporal arcades, in both eyes. Indocyanine green angiography (ICG) showed no further pathology. OCT examination showed no evidence of macular oedema. Patient was treated with an anti-VEGF (ranibizumab) intravitreal injection in the right eye and PRP laser in the left eye.
Follow up examination up to six months post-operatively showed no change in BCVA in either eye. FFA documented regression of retinal neovascularization mainly in the right, while in the left eye there were still areas of vascular leakage across the temporal arcades.
Hypertensive retinopathy is rarely complicated with retinal neovascularization. Treatment with PRP can be undertaken. In our case the use of an intravitreal anti-VEGF agent seemed to halt its progression satisfactory. Further follow up is mandatory to establish its long term efficacy.