Title

Choroidal neovascularization secondary to Grondblad-Strandberg syndrome: case report

Introduction

Objective: To report a clinical case of choroidal neovascularization secondary to Gronblad-Strandberg syndrome in a young patient. Introduction: Grondblad-Strandberg syndrome is characterized by the development of skin lesions described in the appearance of yellowish confluent papules, mainly in skin folds, known as elastic pseudoxanthoma.

Methods

S.R.F.S, 37 years old, female, presented in March 2019 in a routine ophthalmological evaluation at Institutos Visão, worsening of visual acuity (VA) in both eyes, mainly in the right eye (OD), referring to metamorphopsia during reading. The AMSLER grid exam shows distorted DO temporal vision, even maintaining a 20/20 VA in both eyes. In the anamnesis, he also referred to characteristic flexural skin lesions in the neck of undetermined beginning. Biometrics and tonometry without changes.Fundscopy showed angioid streaks on both optic discs, presence of subretinal hemorrhage with central exudation and choroidal neovascularization in OD. It evolved three months later, with worsening of metamorphopsia and decreased visual acuity, 20/40 -2 in RE. In fluorescent retinography it presents in DO: macula with hyperfluorescence increasing during the exam and choroidal neovascularization. On examination of the macula OCT in OD: she had macular edema with a slum thickness of 406 microns. OE without changes.

Results

Currently, intravitreal injections of anti-VEGF are promising in the treatment of these patients, and this was the treatment of choice for this case.The patient received 3 intravitreal injections of anti-VEGF, with an interval of 30 days, with significant reduction of macular edema (thickness 236 microns OD), but with return of the liquid after drug suspension. (thickness 429 microns).

Discussion

Due to the healing of the neovascular process and the permeability defect was maintained, the intravitreal application of dexamethasone was chosen in an attempt to improve the clinical condition and prevent recurrent macular edema).

Keywords

Choroidal neovascularization : Grondblad-Strandberg syndrome: anti - VEGF

Área

CLINICAL CASE

Autores

Michele Costa Barbosa Cardoso, Rafael Yamamoto, Gabriel Cedron, Bruna Rodrigues Vieira