Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy

Purpose: To determine the effectiveness of anti-vascular endothelial growth factor (VEGF) therapy in the setting of optic disc edema secondary to hematologic malignancies. Observations: The report features two patients (one male, one female) in their 70's with biopsy proven hematologic malignan...

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Main Authors: Thomas P. Toohey, Jake Shortt, Nevin John, Salmaan Al-Qureshi, Sanjeewa S. Wickremasinghe
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:American Journal of Ophthalmology Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2451993624001051
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author Thomas P. Toohey
Jake Shortt
Nevin John
Salmaan Al-Qureshi
Sanjeewa S. Wickremasinghe
author_facet Thomas P. Toohey
Jake Shortt
Nevin John
Salmaan Al-Qureshi
Sanjeewa S. Wickremasinghe
author_sort Thomas P. Toohey
collection DOAJ
description Purpose: To determine the effectiveness of anti-vascular endothelial growth factor (VEGF) therapy in the setting of optic disc edema secondary to hematologic malignancies. Observations: The report features two patients (one male, one female) in their 70's with biopsy proven hematologic malignancies who subsequently developed optic disc edema. The patients were commenced on a trial of successive intravitreal Aflibercept 2mg/0.05mL therapy. The best corrected visual acuity for patient 1 improved from 20/50 oculus dexter (OD) and 20/80 oculus sinister (OS), to 20/20 OD (4 lines Early Treatment of Diabetic Retinopathy Study (ETDRS)) and 20/32 OS (4 lines ETDRS). Similarly, patient 2's best corrected visual acuity improved from 20/100 OU to 20/50 OD (3 lines ETDRS) and 20/40 OS (4 lines ETDRS) following initiation of treatment. In addition, optical coherence tomography imaging obtained before and after therapy demonstrated an improvement in both patient's optic disc edema and cystoid macular edema. Conclusions and importance: The findings of this report suggest that in patients with a known hematologic malignancy, optic disc edema and cystoid macular edema may be amenable to anti-VEGF treatment, especially if there are clinical and angiographic features of vascular endothelial growth factor overexpression.
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spelling doaj-art-c122eae80db5465cb6d50dc0510791d22025-08-20T01:57:51ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362024-12-013610209510.1016/j.ajoc.2024.102095Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancyThomas P. Toohey0Jake Shortt1Nevin John2Salmaan Al-Qureshi3Sanjeewa S. Wickremasinghe4Eastern Health, 5 Arnold Street, Box Hill, VIC, 3128, Australia; Corresponding author.Monash Haematology, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, Australia; Department of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC, 3800, AustraliaDepartment of Medicine, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Wellington Rd, Clayton, VIC, 3800, Australia; Department of Neurology, Monash Health, 246 Clayton Road, Clayton, VIC, 3168, AustraliaCentre for Eye Research Australia (CERA), Level 7/32 Gisborne St, East Melbourne VIC 3002, Australia; Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne VIC 3002, AustraliaCentre for Eye Research Australia (CERA), Level 7/32 Gisborne St, East Melbourne VIC 3002, Australia; Royal Victorian Eye and Ear Hospital, 32 Gisborne Street, East Melbourne VIC 3002, AustraliaPurpose: To determine the effectiveness of anti-vascular endothelial growth factor (VEGF) therapy in the setting of optic disc edema secondary to hematologic malignancies. Observations: The report features two patients (one male, one female) in their 70's with biopsy proven hematologic malignancies who subsequently developed optic disc edema. The patients were commenced on a trial of successive intravitreal Aflibercept 2mg/0.05mL therapy. The best corrected visual acuity for patient 1 improved from 20/50 oculus dexter (OD) and 20/80 oculus sinister (OS), to 20/20 OD (4 lines Early Treatment of Diabetic Retinopathy Study (ETDRS)) and 20/32 OS (4 lines ETDRS). Similarly, patient 2's best corrected visual acuity improved from 20/100 OU to 20/50 OD (3 lines ETDRS) and 20/40 OS (4 lines ETDRS) following initiation of treatment. In addition, optical coherence tomography imaging obtained before and after therapy demonstrated an improvement in both patient's optic disc edema and cystoid macular edema. Conclusions and importance: The findings of this report suggest that in patients with a known hematologic malignancy, optic disc edema and cystoid macular edema may be amenable to anti-VEGF treatment, especially if there are clinical and angiographic features of vascular endothelial growth factor overexpression.http://www.sciencedirect.com/science/article/pii/S2451993624001051Macular edemaOptic disc edemaVascular endothelial growth factor
spellingShingle Thomas P. Toohey
Jake Shortt
Nevin John
Salmaan Al-Qureshi
Sanjeewa S. Wickremasinghe
Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy
American Journal of Ophthalmology Case Reports
Macular edema
Optic disc edema
Vascular endothelial growth factor
title Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy
title_full Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy
title_fullStr Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy
title_full_unstemmed Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy
title_short Intravitreal anti-vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy
title_sort intravitreal anti vascular endothelial growth factor therapy in the treatment of vision loss associated with hematologic malignancy
topic Macular edema
Optic disc edema
Vascular endothelial growth factor
url http://www.sciencedirect.com/science/article/pii/S2451993624001051
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