PMC6149836_01
Outcomes at 13 months after ranibizumab treatment (A, B), after 3 loading doses of aflibercept (C) and after 1 year of aflibercept treatment (D). Notes: (A) Thirteen months after treatment with ranibizumab, fluorescein angiography depicts AS around the optic disc and leakage of the dye originating from the CNV, while staining of the fibrotic element of the lesion in the fovea is observed. (B) OCT scan at that point demonstrates subfoveal hyper-reflective tissue associated with CNV and subretinal fibrosis between Bruch's membrane and the retinal pigment epithelium. Intraretinal fluid and cysts and a subtle accumulation of subretinal fluid are also noted. The CFT is 426 mum. (C) The OCT scan following the 3 loading doses of aflibercept reveals resolution of the subretinal fluid with absorption of the intraretinal fluid and significant reduction of the remaining intraretinal cysts. The CFT is reduced to 348 mum. (D) After 1 year of treatment with 7 IVIs of aflibercept, OCT demonstrates further reduction of the intraretinal cysts while the subretinal fibrosis persists. The CFT is 325 mum.. Abbreviations: AS, angioid streaks; CFT, central foveal thickness; CNV, choroidal neovascularization; IVI, intravitreal injection; OCT, optical coherence tomography.
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Fluorescein angiography clearly showed streaks around the optic disc and leakage of the dye originating from the CNV, while staining of the fibrotic element of the foveal lesion was observed (Figure 1A). Optical coherence tomography (OCT) imaging revealed signs of active CNV in OS with intraretinal and subretinal fluid accumulation (Figure 1B). The 3 loading doses of aflibercept led to an improved BCVA of 6/10 in OS, while OCT demonstrated resolution of the subretinal fluid with reduction of the intraretinal fluid (Figure 1C). After a 12-month treatment period and 7 IVIs of aflibercept, BCVA remained at 3/10 in OS, while OCT demonstrated further morphologic improvement as indicated by reduction of the intraretinal fluid (Figure 1D).