Bevacizumab for choroidal neovascularisation in enhanced S-cone syndrome

Doc Ophthalmol. 2016 Oct;133(2):139-143. doi: 10.1007/s10633-016-9555-9. Epub 2016 Jul 16.

Abstract

Introduction: We present a case of enhanced S-cone syndrome (ESCS)-associated choroidal neovascularisation (CNV) treated successfully with intravitreal bevacizumab therapy.

Methods/case report: A 14-year-old with a known retinal dystrophy presented with acute visual deterioration. Fluorescein angiography demonstrated CNV, and treatment was initiated with an anti-vascular endothelial growth factor (anti-VEGF) agent, with significant improvement in vision. Subsequent electroretinogram examination of the patient and her younger sister showed severely reduced rod responses with accentuated fast cone (S-cone only) response, confirming the diagnosis of ESCS as the underlying dystrophy.

Conclusion: CNV is a rare complication of ESCS that is responsive to anti-VEGF therapy. Although cystic retinal lesions may develop in patients with retinal dystrophies due to multiple possible aetiologies, CNV is a known cause of macula oedema in these patients that requires treatment with different agents, namely anti-VEGF therapy. Rapid visual loss in patients with inherited retinal disorders should prompt immediate clinical assessment to exclude CNV, and if CNV is detected, anti-VEGF therapy can preserve vision.

Keywords: Bevacizumab; Choroidal neovascularisation; Electroretinography; Fluorescein angiography; Inherited retinal disease.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Angiogenesis Inhibitors / therapeutic use*
  • Bevacizumab / therapeutic use*
  • Choroidal Neovascularization / drug therapy*
  • Eye Diseases, Hereditary / complications*
  • Female
  • Humans
  • Retinal Degeneration / complications*
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vision Disorders / complications*
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A
  • Bevacizumab

Supplementary concepts

  • Enhanced S-Cone Syndrome