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INSIGHTS INTO PERIFOVEAL EXUDATIVE VASCULAR ANOMALOUS COMPLEX

Mrejen-Uretsky, Sarah, MD*; Le, Hoang Mai, MD; Nghiem-Buffet, Sylvia, MD*; Tabary, Sandrine*; Quentel, Gabriel, MD*; Cohen, Salomon Y., MD, PhD*,†

doi: 10.1097/IAE.0000000000002435
Original Study: PDF Only

Purpose: To report a series of eight patients with perifoveal exudative vascular anomalous complex imaged with optical coherence tomography angiography and the results of anti–vascular endothelial growth factor therapy or laser photocoagulation.

Methods: Retrospective analysis of demographic data, imaging including color pictures, spectral domain optical coherence tomography, and optical coherence tomography angiography, and fluorescein angiography, course, and outcome.

Results: Age at onset ranged from 45 to 84 years (mean ± SD: 68.6 ± 13.7). Five cases were initially misdiagnosed. The perifoveal exudative vascular anomalous complex lesion was unique in seven eyes and located predominantly in the superficial capillary plexus in two eyes, strictly in the deep capillary plexus in two eyes, but observed at the level of both plexi (3 eyes). One patient presented two lesions, one in the superficial capillary plexus and one in the deep capillary plexus. Capillary rarefaction was observed around the lesion in six eyes. Sustainable resolution of exudation could be achieved in 2 patients, one after 2 sessions of focal thermal laser photocoagulation and one after 13 intravitreal injections of anti–vascular endothelial growth factor.

Conclusion: The present series confirms that perifoveal exudative vascular anomalous complex corresponds to a new entity that differs from other conditions associated with capillary aneurysmal lesions. Visual improvement could be obtained after treatment with focal laser or intravitreal anti–vascular endothelial growth factor agents.

Eight patients, aged from 45 to 84 years, presented with perifoveal exudative vascular anomalous complex. Associated findings were myopic fundus changes (2 cases), subretinal deposits (1 case), pigment epithelial changes (1 case), and age-related maculopathy (1 case). Vitreoretinal adhesion and thin epiretinal membrane were observed in four eyes. Optical coherence tomography angiography showed that the aneurysmal lesion could be found either in the superficial or deep retinal capillary plexus and could be associated with capillary rarefaction. Two patients were successfully treated, one with anti–vascular endothelial growth factor injections and one with laser photocoagulation.

*Ophthalmology Center for Imaging and Laser, Paris, France; and

Department of Ophthalmology, University of Paris Est, Creteil, France.

Reprint requests: Salomon Y. Cohen, MD, PhD, Centre Ophtalmologique d'Imagerie et de Laser, 11 Rue Antoine Bourdelle, Paris 75015, France; e-mail: sycsyc75@gmail.com

Supported by CIL-ASSOC, association for research and education, Paris, France.

None of the authors has any financial/conflicting interests to disclose.

© 2019 by Ophthalmic Communications Society, Inc.