RESUMEN
Natalizumab is a monoclonal antibody licensed for the treatment of relapsing-remitting multiple sclerosis (RRMS). It is known to increase the potential risk of developing progressive multifocal leukoencephalopathy (PML). There is current debate in the literature regarding its association with malignant melanoma. Herein, we report a case of a 55-year old lady with RRMS for whom natalizumab therapy was being considered by her neurologist. Her medical history included a choroidal melanoma which had undergone successful treatment. Additionally, in this case study we discuss the issues regarding malignant melanoma risk and recurrence with natalizumab treatment.
Asunto(s)
Neoplasias de la Coroides/inducido químicamente , Factores Inmunológicos/efectos adversos , Melanoma/inducido químicamente , Esclerosis Múltiple Recurrente-Remitente/tratamiento farmacológico , Natalizumab/efectos adversos , Femenino , Humanos , Persona de Mediana EdadRESUMEN
PURPOSE: To present the case of a patient with vitreomacular traction who experienced immediate severe acute complications after ocriplasmin intravitreal injection. METHODS: Case report. RESULTS: A 61-year-old woman with vitreomacular traction underwent ocriplasmin treatment. Within 24 hours after injection, she noticed severe reduction in visual acuity. Spectral domain optical coherence tomography revealed release of vitreous traction, together with widespread subretinal fluid and decreased reflectivity in the outer retina. Ten weeks after treatment, visual acuity improved, although below pretreatment levels, with partial reduction in subretinal fluid. CONCLUSION: Intravitreal ocriplasmin can produce acute visual acuity changes with widespread subretinal fluid and outer retinal ellipsoid zone hyporeflectivity on spectral domain optical coherence tomography. The overall acute and long-term safety profile of ocriplasmin remains unknown.
Asunto(s)
Fibrinolisina/efectos adversos , Fibrinolíticos/efectos adversos , Fragmentos de Péptidos/efectos adversos , Desprendimiento de Retina/inducido químicamente , Trastornos de la Visión/inducido químicamente , Femenino , Humanos , Inyecciones Intravítreas/efectos adversos , Persona de Mediana Edad , Desprendimiento del Vítreo/tratamiento farmacológicoRESUMEN
We report two cases of combined hamatoma of the retina and retinal pigment epithelium (CHR-RPE), illustrated with ultrasonography, optical coherence tomography, fundus fluorescein angiography and indocyanine green angiography images. CHR-RPE could clinically mimic several other retinal conditions. Failure to distinguish it from serious malignancies such as choroidal melanoma or retinoblastoma has led to unnecessary enucleation in the past. Through these case reports and a review of literature, we show the diagnostic features of CHR-RPE, its key differential diagnoses and the management options.