TY - JOUR
T1 - One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation
AU - Singh, Sumit Randhir
AU - Fung, Adrian T.
AU - Fraser-Bell, Samantha
AU - Lupidi, Marco
AU - Mohan, Sashwanthi
AU - Gabrielle, Pierre Henry
AU - Zur, Dinah
AU - Iglicki, Matias
AU - M López-Corell, Paula
AU - Gallego-Pinazo, Roberto
AU - Farinha, Cláudia
AU - Lima, Luiz H.
AU - Mansour, Ahmad M.
AU - Casella, Antonio Marcello
AU - Wu, Lihteh
AU - Silva, Rufino
AU - Uwaydat, Sami H.
AU - Govindahari, Vishal
AU - Arevalo, Jose Fernando
AU - Chhablani, Jay
N1 - Publisher Copyright:
©Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Purpose To report the visual and anatomical outcomes in eyes with peripapillary choroidal neovascularisation (CNV) through 12 months. Methods This was a multicentre, retrospective, interventional case series which included treatment-naïve cases of peripapillary choroidal neovascular membrane (CNVM) with a minimum follow-up of 12 months. Multimodal imaging which comprised optical coherence tomography (OCT), fluorescein angiography and/or indocyanine green angiography was performed at baseline and follow-up visits. OCT parameters included central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and retinal and choroidal thickness at site of CNV. Patients were treated with anti-vascular endothelial growth factors (VEGF) on pro re nata protocol, photodynamic therapy, laser photocoagulation or a combination. Main outcome measures were change in best corrected visual acuity (BCVA) and OCT parameters. Results A total of 77 eyes (74 patients; mean age: 61.9±21.8 years) with a mean disease duration of 9.2±14.1 months were included. BCVA improved significantly from 0.55±0.54 logMAR (20/70) at baseline to 0.29±0.39 logMAR (20/40) at 12 months (p<0.001) with a mean of 4.9±2.9 anti-VEGF injections. CMT, SFCT and retinal thickness at site of CNVM reduced significantly (p<0.001, <0.001 and 0.02, respectively) through 12 months. The most common disease aetiologies were neovascular age-related macular degeneration, and idiopathic, inflammatory and angioid streaks. Age (p=0.04) and baseline BCVA (p<0.001) were significant predictors of change in BCVA at 12 months. Conclusion Peripapillary CNVM, though uncommon, is associated with diverse aetiologies. Anti-VEGF agents lead to significant visual acuity and anatomical improvement in these eyes over long term irrespective of the aetiology.
AB - Purpose To report the visual and anatomical outcomes in eyes with peripapillary choroidal neovascularisation (CNV) through 12 months. Methods This was a multicentre, retrospective, interventional case series which included treatment-naïve cases of peripapillary choroidal neovascular membrane (CNVM) with a minimum follow-up of 12 months. Multimodal imaging which comprised optical coherence tomography (OCT), fluorescein angiography and/or indocyanine green angiography was performed at baseline and follow-up visits. OCT parameters included central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and retinal and choroidal thickness at site of CNV. Patients were treated with anti-vascular endothelial growth factors (VEGF) on pro re nata protocol, photodynamic therapy, laser photocoagulation or a combination. Main outcome measures were change in best corrected visual acuity (BCVA) and OCT parameters. Results A total of 77 eyes (74 patients; mean age: 61.9±21.8 years) with a mean disease duration of 9.2±14.1 months were included. BCVA improved significantly from 0.55±0.54 logMAR (20/70) at baseline to 0.29±0.39 logMAR (20/40) at 12 months (p<0.001) with a mean of 4.9±2.9 anti-VEGF injections. CMT, SFCT and retinal thickness at site of CNVM reduced significantly (p<0.001, <0.001 and 0.02, respectively) through 12 months. The most common disease aetiologies were neovascular age-related macular degeneration, and idiopathic, inflammatory and angioid streaks. Age (p=0.04) and baseline BCVA (p<0.001) were significant predictors of change in BCVA at 12 months. Conclusion Peripapillary CNVM, though uncommon, is associated with diverse aetiologies. Anti-VEGF agents lead to significant visual acuity and anatomical improvement in these eyes over long term irrespective of the aetiology.
KW - age-related macular degeneration (AMD)
KW - angioid streaks
KW - anti-vascular endothelial growth factors (VEGF)
KW - idiopathic intracranial hypertension (IIH)
KW - inflammatory cnv
KW - optic nerve head drusen
KW - peripapillary choroidal neovascularisation (CNV)
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U2 - 10.1136/bjophthalmol-2019-314542
DO - 10.1136/bjophthalmol-2019-314542
M3 - Article
C2 - 31401554
AN - SCOPUS:85070653794
SN - 0007-1161
VL - 104
SP - 678
EP - 683
JO - British Journal of Ophthalmology
JF - British Journal of Ophthalmology
IS - 5
ER -