Título

INTRAVITREAL C3F8 ASSOCIATED WITH AFLIBERCEPT IN POLYPOIDAL CHOROID VASCULOPATHY WITH SUBMACULAR HEMORRHAGE: CASE REPORT

Introdução / Purpose

To evaluate the final visual acuity (VA) in a female patient diagnosed with polypoidal choroid vasculopathy (PCV) associated with submacular hemorrhage in the right eye after treatment with intravitreous (IV) C3F8 (0.3 ml) 100% associated with Aflibercept (loading dose and later PRN).

Material e Método / Methods

A case report of a patient evaluated at the Emergency Department of the Faculty of Medical Sciences of Campinas - UNICAMP, and promptly diagnosed with PCV associated with submacular hemorrhage in the right eye after complementary exams (fundoscopy, OCT-SD, Angiofluorosceinography and Indocyanine Green Angiography (ICGA)). Established IV treatment with 100% C3F8 (single application) and Aflibercept (loading dose and PRN). Set up face down position for 48 hours.

Resultados / Results

Visual acuity at the admission was counting fingers at two meters. After 48 hours of gas application, the hemorrhage was displaced to extramacular region. After 30 days of the loading dose, the VA was 20/25. Control ICGA did not show polypoid lesions.

Discussão e Conclusões / Discussion

The presence of submacular hemorrhage is known to cause irreversible visual loss in many cases, and this is due to different possible mechanisms, such as the toxic action of iron released by hemoglobin, disruptions of the photoreceptor layer caused by fibrin deposition, besides the mechanical barrier that forms between the retina and choriocapillaris. In the present case, the use of IV C3F8 has proved useful for the purpose of displacing bleeding to an extramacular region in order to minimize the possible deleterious effects of hemorrhage on the central region. Regarding the use of anti-VEGF, as evidenced in the PLANET study, Aflibercept IV provided the occlusion of the polypoid lesions evidenced to the ICGA and letter gain in the final VA.

Palavras Chave

Polypoidal Choroid Vasculopathy; Submacular hemorrhage; Anti-VEGF