A 25-year-old male patient with myopic magnum is diagnosed with subretinal neovascular membrane (SNVN) in the left eye (LE).
She had received oral prednisone and triamcinolone transeptal.
On arrival at our centre, the best corrected visual acuity (BCVA) was 0.8 in the right eye (OD) and 0.25 in the left eye.
Fluorescein angiography (FFA) revealed hyperfluorescent points in the posterior pole of the ophthalmic artery (OA) and in the left eye a macular haemorrhage with adjacent RSNV.
Optical coherence tomography (OCT) showed juxtamacular CNV with mild intraretinal edema.
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PDT was performed in the left eye and at 6 months of follow-up the MAVC improved to 0.8 in the left eye, with pigmentation of the nasal edge of the objectifiable lesion by OCT and absence of edema.
Six months later, the AVM had descended to 0.1 in the left eye, the lesion had grown, there was subretinal edema and contrast escaped.
Treatment was indicated by intravitreal injection of ranibizumab (Lucentis®) in the left eye as compassionate use with the usual loading dose consisting of three separate injections one month.
Due to the persistence of subretinal fluid, a fourth injection was indicated, which inactivated the lesion and increased the AVM from 0.25 to 0.7.
MAVC remained stable despite macular subretinal fibrosis in subsequent revisions
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A year later he began with metamorphopsias in the RE.
The MAVC was 0.9 in the RE and the AFG showed a NVC.
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The presence of hyperfluorescent spots in BE, together with the association with CNV, with a diagnosis of IPC.
Intravitreal Lucentis® treatment was started in the RE, with three injections, resulting in angiographic and tomographic inactivity, with an AVM of 0.8 in the BE.
