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Título

IDIOPATHIC POLYPOIDAL VASCULOPATHY

Resumo

OBJECTIVE: To show the efficacy of laser photocoagulation associated with intravitreal antiangiogenic in cases of idiopathic polypoidal vasculopathy.
METHODS: Patient AAP, male, 54 years old, nursing assistant, complaining of low visual acuity in the right eye. Ophthalmoscopy showed a macular edematous halo, microhemorrhages and chronic circinate serous lipid exudation between the macula and the superior temporal vascular arcade; in the left eye hypochromic paramacular areas. Fluorescein angiography showed hyperfluorescence from a vascular lesion between the macula and the superior temporal arcade, already visible in the choroidal phase (abnormality in the internal vessels of the choroid, consisting of a dilated network and multiple aneurysmal terminal protuberances with a polypoidal configuration), which progressed with the course of the examination (leakage) and culminated with staining in the late phase. There was an extensive pooling area inferiorly and temporally to the macula, with areas of hypofluorescence due to hemorrhagic blockage (serosanguineous detachment of the pigment epithelium); other areas of blockade hypofluorescence due to punctiform hemorrhages. We observed less intense hyperfluorescence delimiting the sensory detachment area. In the left eye, areas of hyperfluorescence due to defects in the paramacular pigment epithelium. The diagnostic hypothesis was idiopathic polypoidal choroidal vasculopathy in the right eye.
Results: We opted for watchful waiting until a greater absorption of serosanguinous detachments was achieved. Then, laser photocoagulation and intravitreal antiangiogenic therapy were performed. Final visual acuity was 20/25 in the right eye.
Discussion: The administration of intravitreal antiangiogenic combined with laser photocoagulation proved to be effective as a treatment for cases of idiopathic polypoidal vasculopathy, with good recovery and maintenance of visual acuity.

Referências Bibliográficas

Yannuzzi LASorenson JSpaide RFLipson B Idiopathic polypoidal choroidal vasculopathy. Retina. 1990;101- 8Google ScholarCrossref
.
Spaide RFYannuzzi LASlakter JSSorenson JAOrlock DA Indocyanine green angiography of idiopathic choroidal vasculopathy. Retina. 1995;15100- 110Google ScholarCrossref

Yannuzzi LACiardella ASpaide RF et al. The expanding clinical spectrum of idiopathic polypoidal choroidal vasculopathy. Arch Ophthalmol. 1997;115478- 485