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Gisele Soubrane, Isabelle Aknin, Nathalie Massamba, Claire M Herpe; Dome-shaped macula detachment: new treatment approach in 2 cases. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5945.
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To assess the effectiveness of intravitreal aflibercept for retinal fluid due to dome shaped macula .This entity described in 2008 (D. Gaucher et al) may induce visual impairment resulting from macular fluid accumulation for which no effective treatment has been reported
2 cases experiencing for at least 2 years visual decrease were treated with a loading dose of 2 mg intravitreal aflibercept administered three times every 4 weeks (week 0, 4, and 8). The patients have undergone initially and at every visit a complete ophthalmic examination, including measurement of visual acuity (VA) with ETDRS scale, and of intraocular pressure, spectral-domain optical coherence tomography using a Spectralis EDI protocol (Heidelberg Engineering, Heidelberg, Germany). Adverse event were assessed.
A dramatic improvement in anatomic features was documented. The subretinal fluid resorbed and the area of the retinal detachment decreased by 25%. Central Macular Thickness at 3 months after treatment was of 330 and 300 µm. Visual acuity is to date improved by 4 letters in case 1 and 5 in letters case 2. Further follow up is presently performed.No safety concerns were noted.
Ranibizumab,Bevacizumab as well as photodynamic therapy have been used with little success. Aflibercept has been approved for wet AMD and is thus considered to be a promising treatment of any exsudative maculopathy.. Only a collaborative study would allow to evaluate intravitreal aflibercept efficacy in this unusual disease
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