Intravitreal anti-vascular endothelial growth factor therapy for choroidal neovascularization due to Sorsby macular dystrophy.

PURPOSE To report the first case of intravitreal bevacizumab and ranibizumab to treat choroidal neovascularization secondary to Sorsby macular dystrophy. CASE A 57-year-old male with metamorphopsia, color vision deficits, and ocular family history of Sorsby macular dystrophy was found to have a choroidal neovascular membrane (CNVM) in his left eye. He was initially treated with intravitreal bevacizumab and had visual acuity improvement and resolution of the subretinal fluid on OCT. After 8 injections, he developed presumed mild inflammation secondary to intravitreal bevacizumab and was switched to combination intravitreal bevacizumab/dexamethasone in his left eye, which consistently demonstrated efficacy in stabilizing his vision and the CNVM without producing intraocular inflammation. The right eye later developed the CNVM and he was started on intravitreal bevacizumab in this eye as well. After 8 injections in the right eye, he experienced a similar inflammatory reaction following intravitreal bevacizumab injections and was switched to combination intravitreal bevacizumab/dexamethasone in the right eye as well. Subsequently, he was switched to intravitreal ranibizumab in the left eye alone, which continued to stabilize his vision and OCT and did not cause an inflammatory reaction as he previously experienced with bevacizumab. After 5 ranibizumab injections, he experienced no inflammatory response that he appeared to have with bevacizumab, but chose to switch back to combination intravitreal bevacizumab and dexamethasone due to financial reasons. Initially, in his clinical course, he experienced consistent visual acuity improvements with intravitreal antivascular endothelial growth factor therapy and continues to enjoy functional vision nearly 7 years after his initial symptoms. CONCLUSIONS Intravitreal bevacizumab and ranibizumab demonstrated efficacy in this case in the treatment of CNVM associated with Sorsby macular dystrophy.

[1]  K. S. Cornish,et al.  Visual and Optical Coherence Tomography Outcomes of Intravitreal Bevacizumab and Ranibizumab in Inflammatory Choroidal Neovascularization Secondary to Punctate Inner Choroidopathy , 2011, European journal of ophthalmology.

[2]  A. Navea,et al.  COMBINED THERAPY: Photodynamic Therapy and Bevacizumab to Treat Myopic Neovascular Membranes. One-Year Follow-Up , 2011, Retina.

[3]  P. Rishi,et al.  Intravitreal bevacizumab for choroidal neovascular membrane associated with Best's vitelliform dystrophy , 2010, Indian journal of ophthalmology.

[4]  K. Emi,et al.  Severe intraocular inflammation after intravitreal injection of bevacizumab. , 2010, Ophthalmology.

[5]  Saad A Waheeb,et al.  Idiopathic choroidal neovascular membrane in a young female , 2009, Oman journal of ophthalmology.

[6]  U. Schmidt-Erfurth,et al.  Choroidal neovascularization secondary to Sorsby fundus dystrophy treated with systemic bevacizumab (Avastin). , 2007, Acta ophthalmologica Scandinavica.

[7]  P. Rosenfeld,et al.  Systemic bevacizumab (Avastin) therapy for neovascular age-related macular degeneration: twenty-four-week results of an uncontrolled open-label clinical study. , 2006, Ophthalmology.

[8]  M. Clarke,et al.  TIMP3 mutation in Sorsby's fundus dystrophy: molecular insights , 2005, Expert Reviews in Molecular Medicine.

[9]  N. Lee,et al.  Successful photodynamic therapy for subretinal neovascularisation due to Sorsby’s fundus dystrophy: 1 year follow up , 2003, The British journal of ophthalmology.

[10]  L. Claesson‐Welsh,et al.  A novel function for tissue inhibitor of metalloproteinases-3 (TIMP3): inhibition of angiogenesis by blockage of VEGF binding to VEGF receptor-2 , 2003, Nature Medicine.

[11]  N. Ohba,et al.  Sorsby's fundus dystrophy in two Japanese families with unusual clinical features. , 1999, Japanese journal of ophthalmology.

[12]  R. W. Scott,et al.  Cloning and characterization of human tissue inhibitor of metalloproteinases-3. , 1994, DNA and cell biology.

[13]  A. Bird,et al.  Sorsby's fundus dystrophy. A clinical study. , 1989, Ophthalmology.

[14]  C. Puliafito,et al.  Thirty-two month follow-up of successful treatment of choroidal neovascularization from angioid streaks with intravitreal bevacizumab. , 2009, Ophthalmic surgery, lasers & imaging : the official journal of the International Society for Imaging in the Eye.

[15]  J. Gibson,et al.  Sorsby's fundus dystrophy: A case report of 24 years follow-up with electrodiagnostic tests and indocyanine green angiography , 1999, Eye.

[16]  J. Greenberg,et al.  SORSBY'S FUNDUS DYSTROPHY: A South African Family with a Point Mutation on the Tissue Inhibitor of Metalloproteinases‐3 Gene on Chromosome 22 , 1995, Retina.

[17]  A. Bird,et al.  RECURRENT CHOROIDAL NEOVASCULARIZATION AFTER LASER PHOTOCOAGULATION IN SORSBY'S FUNDUS DYSTROPHY , 1994, Retina.

[18]  D. Barclay,et al.  One-year follow-up , 1975 .