Background: Acquired vitelliform lesions is the disorder which shows the yellowish subretinal accumulation is present bilaterally and is often associated with retinal pigment epithelial detachments (PED). The previous report described that anti-vascular endothelial growth factor (VEGF) therapy is ineffective, ultimately resulting in decreased vision. In this paper, we will describe the findings of 7 eyes of 6 cases which showed AVLs associated with PED and could be followed up over a long period of time in our hospital.
Case: We reviewed 7 eyes of 6 patients (6 eyes of 5 men and 1 eye of 1 woman; average age 74.0±4.5 years). The mean follow-up period was 89±76 months. The 4 eyes underwent photodynamic therapy or anti-VEGF therapy or both. In two eyes, PED regressed at 16 months and 98 months after the initial treatment, respectively. However, PED was unchanged in one eye, and choroidal neovascularization (CNV) occurred in the remaining one eye and a substantial change occurred in the pathological condition. Regarding the three eyes followed up without treatment, there was no regression of PED in one eye, despite a gradual change in the morphology, and PED regressed spontaneously in the remaining two eyes. The baseline logMAR visual acuity was initially 0.07±0.17, which declined to 0.35±0.13 at the final examination. All cases showed visual deterioration.
Conclusions: AVLs associated with PED may show regression of PED over a long period of time although the therapeutic effect is uncertain. Prognosis of visual acuity is poor in a long-term course. Although rare, attention should be paid to CNV occurrence.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 593-602, 2019.