Purpose:
Describe the advantages of Intravitreal Ranibizumab in a case of choroidal macular nevus associated with subretinal neovascularization and a macular pucker.
Methods:
We present the case report of a 70-year-old man with visual acuity of 20/20 in his right eye in year 2005 in whom the diagnosis of macular nevus was made ( a pigmented, well defined, not elevated lession of two disk diameter size with some drusen overlying ). In february of 2008 he referred a decrease in his visual acuity of the right eye ( 20/50 ). His fundus examination suggested subretinal neovascularization, so we made an optical coherence tomography and a fluorescein angiography which confirmed the macular choroidal nevus with subretinal neovascularization. Our patient was treated with three intravitreal Ranibizumab injections and two months later he referred important visual acuity improvement (20/25), the neovascularization had dissapeared and the choroidal nevus had decreased until being almost imperceptible. In year 2010 he referred again a decrease in his visual acuity of the right eye ( visual acuity 20/32 ), the fundus examination and optical coherence tomography revealed a macular pucker, but there were no signs of choroidal neovascularization .
Results:
The treatment with ranibizumab was successful in our patient, achieving to date the disappearance of the choroidal neovascularization associated with choroidal macular nevus and improving his visual acuity.
Conclusions:
Choroidal neovascularization associated with choroidal macular nevus is not a frequent complication. Besides, there is very few biblography about the use of antivascular endotelial grow factor antibodies (anti-VEGF) in these cases. In our case report, Ranibizumab seems to be an effective treatment for choroidal neovascularization associated to choroidal macular nevus, achieving good results to date ( even 3 years after the intravitreal injections ).
Keywords: choroid: neovascularization • macula/fovea