Choroidal neovascular membrane following hormonal stimulation for in vitro fertilization

Eur J Ophthalmol. 2015 Jul 30;25(5):e95-7. doi: 10.5301/ejo.5000607.

Abstract

Purpose: To report the onset of choroidal neovascularization (CNV) following hormonal stimulation for in vitro fertilization (IVF) in a healthy young woman.

Methods: A 31-year-old woman presented with visual impairment following hormonal stimulation for IVF. Clinical history was collected and best-corrected visual acuity (BCVA), complete eye examination, optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography were -performed.

Results: Clinical history was negative with the exception of the use of medications for IVF in the previous weeks. Ocular examination revealed the presence of a CNV in the right eye, confirmed by OCT and FA, with a BCVA of 0.7 decimal units. Possible ocular and systemic diseases associated with CNV development were investigated and excluded. Treatment with 3 monthly intravitreal injections of anti-vascular endothelial growth factor (VEGF) was effective in reducing CNV size and restoring visual acuity.

Conclusions: This is the first report describing the development of CNV following hormonal stimulation for IVF. The development of CNV may be associated with changes of sex hormones, cytokines, and angiogenic factor levels, including VEGF, induced by hormonal stimulation.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / therapeutic use
  • Buserelin / adverse effects
  • Choroidal Neovascularization / chemically induced*
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy
  • Coloring Agents
  • Female
  • Fertility Agents, Female / adverse effects*
  • Fertilization in Vitro*
  • Fluorescein Angiography
  • Follicle Stimulating Hormone, Human / adverse effects
  • Humans
  • Indocyanine Green
  • Intravitreal Injections
  • Progesterone / adverse effects
  • Recombinant Proteins / adverse effects
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Coloring Agents
  • Fertility Agents, Female
  • Follicle Stimulating Hormone, Human
  • Recombinant Proteins
  • Vascular Endothelial Growth Factor A
  • follitropin alfa
  • Progesterone
  • Indocyanine Green
  • Buserelin