PMC4258923_01
(a) Infrared fundus photo, showing vitreous hemorrhage in the right eye; (b, c) optical coherence tomography, showing no macular abnormalities; (d) infrared fundus photo, showing sea fan neovascularization at the temporal periphery; (e-g) fluorescein angiography, showing leakage from the neovascularization and ischemia in the periphery.
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A fluorescein angiography was performed to evaluate the extent of retinopathy, confirming leakage from the sea fan neovascularization in the right eye, with ischemia in the periphery (Figure 1). Optical coherence tomography (OCT) was normal in both eyes (Figures 1 and 2).
(a, b) Infrared fundus photo and optical coherence tomography in the left eye, totally normal; (c, d) fluorescein angiography, showing small ischemic areas at the temporal periphery of the left eye.
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In the left eye, only small ischemic areas in the temporal periphery were detected (Figure 2). Optical coherence tomography (OCT) was normal in both eyes (Figures 1 and 2).
(a-d) Fluorescein angiography, showing improvement of vitreous hemorrhage and slight regression of neovascularization, but presence of ischemic areas, one week after intravitreal ranibizumab injection; (e-h) fluorescein angiography, showing total absorption of vitreous hemorrhage, regression of neovascularization and ischemia at the periphery one month after intravitreal ranibizumab injection; (i-l) fluorescein angiography, showing laser photocoagulation spots in the previous ischemic areas, no recurrence of vitreous hemorrhage, and regression of neovascularization compared to baseline.
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One week after injection, his BCVA was 6/9 in the right eye and fundus examination demonstrated improvement of vitreous hemorrhage, as well as regression of the sea fan neovascularization, confirmed by fluorescein angiography (Figure 3). One month after injection, the BCVA was 6/6 in both eyes, the vitreous hemorrhage was totally absorbed, and the retinal neovascularization further regressed (Figure 3). Three months later, there was no recurrence of the neovascularization, as it is depicted on fluorescein angiography (Figure 3) and the BCVA was 6/6, remaining stable at the 9-month follow-up (Figure 4), while no adverse events were observed.
(a, b) Infrared fundus photo of the right eye, showing no vitreous hemorrhage and presence of fibrotic tissue at the site of previous neovascularization, as well as presence of laser photocoagulation spots in the periphery; (c-e) fluorescein angiography, showing coverage of previous ischemic areas with scatter laser photocoagulation and improvement of sea fan neovascularization, with only slight leakage hyperfluorescence in the photocoagulated area.
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Three months later, there was no recurrence of the neovascularization, as it is depicted on fluorescein angiography (Figure 3) and the BCVA was 6/6, remaining stable at the 9-month follow-up (Figure 4), while no adverse events were observed.