停止抗VEGF治疗后圆顶状黄斑难治性视网膜下积液的矛盾解决
Paradoxical resolution of refractory subretinal fluid in dome-shaped macula after discontinuation of anti-VEGF therapy.
摘要(中文译文)
慢性视网膜下积液（SRF）是圆顶状黄斑（DSM）的常见并发症，但其最佳管理策略仍不明确。本文报道一例与DSM相关的慢性SRF在停用抗血管内皮生长因子（anti-VEGF）治疗后自发消退的病例。患者为一名70多岁晚期女性，左眼患有DSM并伴有慢性SRF，在19个月内接受了多种抗VEGF药物治疗，包括雷珠单抗、阿柏西普和法瑞西单抗。尽管持续治疗，其SRF仍持续存在，最佳矫正视力（BCVA）稳定在20/20至20/25。停止治疗45天后，光学相干断层扫描显示SRF完全消退。在随后26个月的观察中未再给予治疗，视网膜保持干燥，BCVA保持稳定。这提示在DSM中，对抗VEGF治疗难治的慢性SRF可能在停止治疗后自发消退。对于特定患者，观察是一种合理的管理策略，可尽量减少不必要的注射及相关风险。
Abstract
Chronic subretinal fluid (SRF) is a common complication of dome-shaped macula (DSM), yet its optimal management remains uncertain. This paper presents a case of spontaneous resolution of chronic SRF associated with DSM following discontinuation of anti-vascular endothelial growth factor (anti-VEGF) therapy. The patient, in her late 70s, with DSM and chronic SRF in the left eye was treated with multiple anti-VEGF agents, including ranibizumab, aflibercept and faricimab, over 19 months. Despite ongoing therapy, her SRF persisted and best-corrected visual acuity (BCVA) remained stable at 20/20 to 20/25. 45 days after treatment cessation, optical coherence tomography showed complete resolution of SRF. Over 26 months of subsequent observation without further treatment, the retina remained dry and BCVA remained stable. This suggests that in DSM, chronic SRF refractory to anti-VEGF therapy may spontaneously resolve after discontinuing treatment. Observation is a reasonable management strategy in specific patients to minimise unnecessary injections and associated risks.
如何引用
AMA
Trevor Lin, Steven M Cohen. Paradoxical resolution of refractory subretinal fluid in dome-shaped macula after discontinuation of anti-VEGF therapy.. BMJ case reports. 2026; doi:10.1136/bcr-2026-273240.
APA
Trevor Lin, Steven M Cohen (2026). Paradoxical resolution of refractory subretinal fluid in dome-shaped macula after discontinuation of anti-VEGF therapy.. BMJ case reports. https://doi.org/10.1136/bcr-2026-273240
GB/T 7714
Trevor Lin, Steven M Cohen. Paradoxical resolution of refractory subretinal fluid in dome-shaped macula after discontinuation of anti-VEGF therapy.[J]. BMJ case reports, 2026 doi:10.1136/bcr-2026-273240.
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