Intravitreal Ranibizumab for Treatment of Posttraumatic Choroidal Neovascularization: a Case Report

Abstract

An analysis of the case of applying a course of fibrinolytic therapy and one intravitreal injection of an angiogenesis inhibitor in a patient with traumatic rupture of the choroid complicated by choroidal neovascularization (CNV) is presented. Patient B., 20 years old, complained of a lack of objective vision after a blunt injury to his right eye in March 2018. Visual acuity decreased to 0.01 (ETDRS 0 characters). During the examination revealed: partial hemophthalmus, rupture of the choroid, Berlin retinal opacification. Local fibrinolytic conservative therapy with positive dynamics was carried out in the form of increasing visual acuity to 0.3 (ETDRS 21 characters) and partial resolution of hemophthalmus. According to optical coherence tomography angiography (OCTA), minimally active CNV was detected. Due to the weak activity of the pathological process, a decision was made on dynamic observation. A follow-up examination in August 2018 revealed an increase in CNV activity according to OCTA and fluorescence angiography (FAG), in connection with which intravitreal administration of ranibizumab (lucentis) was performed. Subsequently, the patient was under dynamic observation for one year. Positive dynamics was revealed in the form of an increase in visual acuity, first to 0.7 (ETDRS 48 characters) 3 months after intravitreal injection, and after a year — to 0.9 (ETDRS 55 characters). After treatment according to OCTA and FAG, the activity of CNV was not determined. Despite the favorable result of treatment, further monitoring of the patient is necessary, since the long-term prospects for maintaining the achieved high visual functions remain unclear due to the insufficient experience in treating patients with this pathology according to the literature.