Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report

Hidetaka Noma,1 Hiroshi Shimizu,1 Tatsuya Mimura21Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, 2Department of Ophthalmology, Medical Center East, Tokyo Women's Medical University, Tokyo, JapanAbstract: Central retinal vein occlusion (CRVO) is...

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Autores principales:	Noma H, Shimizu H, Mimura T
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/4e06f3b5b2454da3b4c8be59f50bb33c
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spelling	oai:doaj.org-article:4e06f3b5b2454da3b4c8be59f50bb33c2021-12-02T03:07:19ZUnilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report1177-54671177-5483https://doaj.org/article/4e06f3b5b2454da3b4c8be59f50bb33c2013-05-01T00:00:00Zhttp://www.dovepress.com/unilateral-macular-edema-with-central-retinal-vein-occlusion-in-system-a13010https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Hidetaka Noma,1 Hiroshi Shimizu,1 Tatsuya Mimura21Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, 2Department of Ophthalmology, Medical Center East, Tokyo Women's Medical University, Tokyo, JapanAbstract: Central retinal vein occlusion (CRVO) is frequent in patients with systemic lupus erythematosus (SLE), but the treatment of the macular edema with this disease is extremely difficult. We report a case of cystoid macular edema (CME) secondary to unilateral CRVO in a patient with SLE that responded to intravitreous injection of an anti-vascular endothelial growth factor (VEGF) agent. A 33-year-old Japanese woman was referred to our department with unilateral impairment of vision. Microperimetry (MP-1) showed a cessation of foveal sensitivity. Fluorescein angiography showed CME without ischaemia of the macular region or peripheral retina (nonischemic CRVO). A diagnosis of CME and unilateral nonischemic CRVO combined with SLE was made and intravitreous anti-VEGF therapy was given. A sample of aqueous humor was harvested at the start of intravitreous injection after obtaining informed consent. Then the levels of VEGF and monocyte chemotactic protein (MCP)-1 were measured in the aqueous humor by enzyme-linked immunosorbent assay, revealing that VEGF was 234 pg/mL and MCP-1 was 501 pg/mL. Two weeks later, left eye vision improved to 20/20. Optical coherence tomography (OCT) showed considerable amelioration of retinal swelling and CME. MP-1 showed a marked increase of foveal sensitivity. However, she had recurrence of edema 3 months later. After harvesting aqueous humor again, intravitreous injection of an anti-VEGF agent was repeated for CME. The aqueous VEGF and MCP-1 levels were 156 pg/mL and 360 pg/mL, respectively. These findings suggest that inflammation was improved by intravitreous injection of bevacizumab. Intravitreous injection of anti-VEGF agents may be effective for CME due to nonischemic CRVO in SLE patients if their inflammatory factor levels are low..Keywords: systemic lupus erythematosus, central retinal vein occlusion, cystoid macular edema, anti-vascular endothelial growth factor agent, vascular endothelial growth factor, monocyte chemotactic protein-1Noma HShimizu HMimura TDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 865-867 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Noma H Shimizu H Mimura T Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report
description	Hidetaka Noma,1 Hiroshi Shimizu,1 Tatsuya Mimura21Department of Ophthalmology, Yachiyo Medical Center, Tokyo Women's Medical University, 2Department of Ophthalmology, Medical Center East, Tokyo Women's Medical University, Tokyo, JapanAbstract: Central retinal vein occlusion (CRVO) is frequent in patients with systemic lupus erythematosus (SLE), but the treatment of the macular edema with this disease is extremely difficult. We report a case of cystoid macular edema (CME) secondary to unilateral CRVO in a patient with SLE that responded to intravitreous injection of an anti-vascular endothelial growth factor (VEGF) agent. A 33-year-old Japanese woman was referred to our department with unilateral impairment of vision. Microperimetry (MP-1) showed a cessation of foveal sensitivity. Fluorescein angiography showed CME without ischaemia of the macular region or peripheral retina (nonischemic CRVO). A diagnosis of CME and unilateral nonischemic CRVO combined with SLE was made and intravitreous anti-VEGF therapy was given. A sample of aqueous humor was harvested at the start of intravitreous injection after obtaining informed consent. Then the levels of VEGF and monocyte chemotactic protein (MCP)-1 were measured in the aqueous humor by enzyme-linked immunosorbent assay, revealing that VEGF was 234 pg/mL and MCP-1 was 501 pg/mL. Two weeks later, left eye vision improved to 20/20. Optical coherence tomography (OCT) showed considerable amelioration of retinal swelling and CME. MP-1 showed a marked increase of foveal sensitivity. However, she had recurrence of edema 3 months later. After harvesting aqueous humor again, intravitreous injection of an anti-VEGF agent was repeated for CME. The aqueous VEGF and MCP-1 levels were 156 pg/mL and 360 pg/mL, respectively. These findings suggest that inflammation was improved by intravitreous injection of bevacizumab. Intravitreous injection of anti-VEGF agents may be effective for CME due to nonischemic CRVO in SLE patients if their inflammatory factor levels are low..Keywords: systemic lupus erythematosus, central retinal vein occlusion, cystoid macular edema, anti-vascular endothelial growth factor agent, vascular endothelial growth factor, monocyte chemotactic protein-1
format	article
author	Noma H Shimizu H Mimura T
author_facet	Noma H Shimizu H Mimura T
author_sort	Noma H
title	Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report
title_short	Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report
title_full	Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report
title_fullStr	Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report
title_full_unstemmed	Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report
title_sort	unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/4e06f3b5b2454da3b4c8be59f50bb33c
work_keys_str_mv	AT nomah unilateralmacularedemawithcentralretinalveinocclusioninsystemiclupuserythematosusacasereport AT shimizuh unilateralmacularedemawithcentralretinalveinocclusioninsystemiclupuserythematosusacasereport AT mimurat unilateralmacularedemawithcentralretinalveinocclusioninsystemiclupuserythematosusacasereport
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Unilateral macular edema with central retinal vein occlusion in systemic lupus erythematosus: a case report

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