Supplementary Material for: Neovascular Maculopathy after laser 2RT in a Young Myopic Patient: A Case Report

Introduction

Laser photobiomodulation, including 2RT (Retinal Rejuvenation Therapy), is a system which selectively targets the retinal pigment epithelium (RPE) by a concise 3 ns pulse duration. The advantage of this laser system over the traditional thermal laser is that the pulsed, very short duration laser effects can be titrated as spatially confined photodisruptors without resultant conductive thermal spread and therefore collateral damage. It has been investigated primarily in age-related macular degeneration (AMD), particularly in decreasing drusen and slowing the rate of AMD progression.
In this case, we have described a case of neovascular maculopathy occurring shortly after 2RT in a young myopic patient.

Case presentation

We report the case of a 28-year-old male who presented with unilateral visual impairment following laser 2RT. Two months before, he was subjected to photorefractive keratectomy (PRK) for moderate myopia (-3.00 D). The baseline Optical Coherence tomography (OCT) imaging revealed “sharp-peaked” pigment epithelium detachment PED in subfoveal area.
Fluorescein angiography (FA) indicated a focal area of irregular foveal hyperfluorescence.
Observation was advised and laser 2RT was performed. However, one month later, the patient developed a neovascular lesion in the same eye, confirmed by OCT-angiography, requiring urgent intravitreal anti-VEGF therapy.

Discussion

In summary, this case illustrates a progressive maculopathy culminating in choroidal neovascularization (CNV) triggered by laser 2RT in a young myopic patient.