Successful treatment of stellate multiform amelanotic choroidopathy with photodynamic therapy: A case report

Q3 Medicine

American Journal of Ophthalmology Case Reports Pub Date : 2025-08-19 DOI:10.1016/j.ajoc.2025.102410

Luuk van Gorcom , Mehmet Ikinci , Sankha Amarakoon

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引用次数: 0

Abstract

Purpose

To report a case of stellate multiform amelanotic choroidopathy (SMACH) with focal hyperfluorescence on indocyanine green angiography (ICGA), successfully treated with photodynamic therapy (PDT).

Observations

An 18-year-old male presented with subretinal fluid (SRF) overlying an irregular lesion in the inner choroid. A diagnosis of probable idiopathic macular neovascularization was made; treatment with intravitreal injections (IVIs) of anti-vascular endothelial growth factor (VEGF) agents showed no effect. The diagnosis was later revised to SMACH due to distinctive features on optical coherence tomography (OCT) and ICGA. Typically, no focal leakage is observed on ICGA in SMACH, and no successful treatment has been previously described. However, our case presented with focal leakage on ICGA, and treatment with full-dose PDT led to complete resolution of SRF.

Conclusions and importance

Diagnosing and treating SMACH can be challenging. No effective treatment has been reported to date. We describe a case with focal leakage on ICGA successfully treated with full-dose PDT. We suggest full-dose PDT as the first-line treatment of SMACH with associated focal leakage on ICGA.

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光动力疗法成功治疗星状多形态无色变性脉络膜病1例

目的报告1例星状多形态无色素变性脉络膜病（SMACH）伴吲吲吲胺绿血管造影（ICGA）局灶性高荧光，并采用光动力疗法（PDT）成功治疗。摘要一例18岁男性视网膜下积液（SRF）覆盖内脉络膜不规则病变。诊断为可能的特发性黄斑新生血管；玻璃体内注射抗血管内皮生长因子（VEGF）药物治疗无明显效果。由于光学相干断层扫描（OCT）和ICGA的不同特征，诊断后来被修改为SMACH。通常情况下，SMACH患者在ICGA上未观察到局灶性渗漏，以前也没有成功的治疗方法。然而，我们的病例表现为ICGA的局灶性渗漏，全剂量PDT治疗导致SRF完全消退。结论和重要性SMACH的诊断和治疗具有挑战性。迄今为止尚无有效治疗的报告。我们描述了一个病例局灶性渗漏成功治疗的ICGA全剂量PDT。我们建议将全剂量PDT作为SMACH伴ICGA灶性渗漏的一线治疗。

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来源期刊

American Journal of Ophthalmology Case Reports Medicine-Ophthalmology

CiteScore

2.40

自引率

0.00%

发文量

513

审稿时长

16 weeks

期刊介绍： The American Journal of Ophthalmology Case Reports is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished case report manuscripts directed to ophthalmologists and visual science specialists. The cases shall be challenging and stimulating but shall also be presented in an educational format to engage the readers as if they are working alongside with the caring clinician scientists to manage the patients. Submissions shall be clear, concise, and well-documented reports. Brief reports and case series submissions on specific themes are also very welcome.