Título / Title

CHOROIDAL NEOVASCULARIZATION SECUNDARY TO BEST VITELLIFORM MACULAR DYSTROPHY DETECTED BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY

Introdução / Purpose

Best vitelliform macular dystrophy (BVMD) is a hereditary condition that causes childhood-onset macular dystrophy. In rare cases, BVMD is accompanied by formation of a choroidal neovascular membrane (CNVM). We report a case of CNVM secondary to BVMD in a 21-year-old woman that was detected using optical coherence tomography angiography (OCTA), a new noninvasive diagnostic modality that detects motion contrast in repeated B-scans to identify blood flow within vessels.

Material e Método / Methods

A Case Report. We used a Triton swept source (SS) OCTA (Topcon, Japan), that it is based on splitspectrum amplitude decorrelation angiography (SSADA) and provides segmentation of en-face automated slabs guided by OCT B-scans within macular cubes via a software algorithm (IMAGEnet 6) as well as fundus color pictures.

Resultados / Results

A 21-year-old woman presented at CLINOS Eye Hospital, Feira de Santana BA Brazil, with a complaint of decreased vision in his right eye of 2 month’s duration. She reported that he had been diagnosed with BVMD 2 years earlier. On examination, best-corrected visual acuity was 20/40 in the right eye and 20/20 in the left eye. Anterior segment examination was unremarkable. Based on fundus examination, autofluorescence (Fig1) and swept-source OCT findings (Fig2), the patient was diagnosed with suspected CNVM associated with BVMD. OCTA revealed a branching pattern of blood flow within the yellow lesion in the right eye (Fig3). The findings were characteristic of type 2 CNVM. There were no such abnormal vascular patterns in the left eye. The patient was indicate to receive monthly anti-VEGF injections for 3 months.

Discussão e Conclusões / Conclusion

CNVM in Best VMD is rare but treatable. It is imperative, however, to differentiate it from degenerative untreatable natural disease progression. Conventionally, CNVM was diagnosed by Fluorescein Angiography (FA), but OCTA allows easier CNVM diagnosis compared to FA. Nevertheless, there are limitations of using OCTA in a young population, and to detect CNVM in the peripheral retina.

Palavras Chave

Best Disease
Best vitelliform macular dystrophy
Choroidal neovascular membrane
Optical coherence tomography angiography

Area

CLINICAL RETINA