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OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 4  |  Page : 556

Management of retinal artery macroaneurysm exudation in Wyburn-Mason syndrome with intravitreal ranibizumab


Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India

Date of Web Publication22-Mar-2019

Correspondence Address:
Dr. Vikas Khetan
Senior Consultant, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Medical Research Foundation, 18 College Road, Chennai - 600 006, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1497_18

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How to cite this article:
Naik AU, Bhende M, Selvakumar A, Khetan V. Management of retinal artery macroaneurysm exudation in Wyburn-Mason syndrome with intravitreal ranibizumab. Indian J Ophthalmol 2019;67:556

How to cite this URL:
Naik AU, Bhende M, Selvakumar A, Khetan V. Management of retinal artery macroaneurysm exudation in Wyburn-Mason syndrome with intravitreal ranibizumab. Indian J Ophthalmol [serial online] 2019 [cited 2019 Apr 23];67:556. Available from: http://www.ijo.in/text.asp?2019/67/4/556/254716



A 21-year-old female with a history of right-sided thalamostriate arteriovenous malformation (AVM) between the right anterior cerebral artery and right ophthalmic artery presented with decreased vision in the right eye. Best-corrected visual acuity (BCVA) was 6/18, N12 in the right eye and 6/6, N6 in the left eye. Fundus revealed a retinal racemose haemangioma (RRH) with a retinal artery macroaneurysm (RAM) [Figure 1]a. The left eye was within normal limits. A swept-source optical coherence tomography angiography (SSOCT-A) demonstrated marked retinal thickening and subretinal fluid (SRF) on B-scan [Figure 1]b with angiographic image demonstrating the high blood flow RAM lesion in superficial retina [[Figure 1]b, inset]. A diagnosis of Wyburn-Mason syndrome with a leaking RAM was made. Intravitreal ranibizumab (0.5 mg in 0.1 ml) injection was administered. At 1-month follow-up, the thickening and SRF had resolved [Figure 1]c and [Figure 1]d. The arteriolar and venular turgidity too had decreased. At the last follow-up, at a period of 4 months post-injection, there was no recurrence and BCVA in the right eye was maintained at 6/9, N6. To the best of our knowledge, this is the first report of RAM exudation in a known case of Wyburn-Mason syndrome which was successfully managed with intravitreal ranibizumab.
Figure 1: Retinal artery macroaneurysm exudation with retinal racemose haemangioma in Wyburn-Mason syndrome. Clinical picture (a) with corresponding swept-source optical coherence tomography (SSOCT) B-scan and angiographic images (b) at presentation. At 1-month follow-up post-intravitreal ranibizumab, there was a significant reduction in retinal thickening and subretinal fluid, as seen clinically (c) and in OCT B-scan image (d)

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.




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