Combined therapy with intravitreal aflibercept and subtenon corticosteroids in eyes with severe diabetic papillopathy: two case reports.

Abstract

BACKGROUND:

Diabetic papillopathy is a rare diagnosis of exclusion characterized by unilateral or bilateral optic disc edema with variable degrees of visual loss. Although the visual prognosis has been generally reported as favorable, the presence of severe disc edema associated with macular edema prompts the need for treatment. We present a specific and unreported therapeutic approach consisting of intravitreal aflibercept and subtenon triamcinolone acetonide injections in two patients with evidence of diabetic papillopathy and macular edema.

CASE PRESENTATION:

In the first case, a 60-year-old Caucasian woman affected by type II diabetes mellitus presented with fundoscopic evidence of sequential bilateral optic disc edema associated with acute severe visual loss in both eyes. The second patient, a diabetic 57-year-old Caucasian male, presented with sudden painless visual loss in his left eye. Multimodal imaging and systemic findings correlated towards an infrequent diagnosis of diabetic papillopathy. In a period of 5-7 weeks after treatment, both patients experienced almost full visual and anatomical recovery. A steady situation was observed at 12 months of follow-up.

CONCLUSIONS:

Both our cases displayed a severe grade of optic disc edema, which was optimally reversed with intravitreal aflibercept and subtenon triamcinolone acetonide leading to a relatively rapid and safe improvement in visual acuity.

• Authors: Ilir Arapi, Piergiorgio Neri, Alfonso Giovannini, Arjeta Grezda
• Journal: Journal of medical case reports (J Med Case Rep) Vol. 15 Issue 1 Pg. 518 (Oct 22 2021) ISSN: 1752-1947 [Electronic] England
• PMID: 34674724 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2021. The Author(s).

Chemical References

• Glucocorticoids
• Recombinant Fusion Proteins
• aflibercept
• Receptors, Vascular Endothelial Growth Factor

Topics

• Diabetes Mellitus, Type 2 (complications)
• Female
• Glucocorticoids
• Humans
• Male
• Middle Aged
• Papilledema
• Receptors, Vascular Endothelial Growth Factor
• Recombinant Fusion Proteins
• Vitreous Body