Aneurysmal type 2 neovascularization: A new entity
Por:
Montero-Hernandez, J., Remoli-Sargues, L., Monferrer-Adsuara, C., Castro-Navarro, V., Navarro-Palop, C., Cervera-Taulet, E.
Publicada:
1 feb 2024
Ahead of Print:
1 feb 2024
Resumen:
Purpose. - To report three cases of aneurysmal type 2 neovascularization
(AT2), a novel entity within the pachychoroid disease (PD) spectrum.
Methods. - We conducted an observational retrospective study of three
patients with subretinal polyps treated with intravitreal aflibercept.
We reviewed clinical and imaging data of the three patients. Best
corrected visual acuity (BCVA), central macular thickness (CMT),
choroidal subfoveal thickness, choroidal thickness under the polyps and
the presence of a dry macula were assessed at baseline and throughout
the follow-up. Results. - All of the patients showed granular
hypoautofluorescence on fundus autofluorescence. Indocyanine green
angiography revealed prominent hyperfluorescent branching vascular
networks ending in multiple aneurysmal dilatations. Optical coherence
tomography (OCT) demonstrated that the aneurysmal lesions were localized
in the subretinal space. Additionally, OCT showed retinal pigment
epithelial microtears, the double-layer sign and pachyvessels. En face
OCT-A perfectly defined prominent telangiectatic branching vascular
networks in all the patients, but only revealed polyps in two out of the
three patients. Cross-sectional OCT-A demonstrated polyps as patchy
circular hypoflow signals in each case. After the intravitreal
treatment, BCVA remained unimproved in all of the patients, despite
decreased CMT and achievement of a dry macula, as a result of the
development of subretinal fibrosis. Conclusion. - In summary, we
describe a new entity within the spectrum of PD, which we have termed
AT2. This novel disease is characterized by the presence of aneurysmal
dilata- tions in the subretinal space, along with the typical features
of PD, such as choroidal vascular hyperpermeability, thickening of the
choroid , pachyvessels. (c) 2023 Elsevier Masson SAS. All rights
reserved.
Filiaciones:
Univ Valencia, Consorcio Hosp Gen, Dept Ophthalmol, Ave Tres Cruces 2,
Valencia 46014, Spain
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