One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation

Sumit Randhir Singh, Adrian T. Fung, Samantha Fraser-Bell, Marco Lupidi, Sashwanthi Mohan, Pierre Henry Gabrielle, Dinah Zur, Matias Iglicki, Paula M López-Corell, Roberto Gallego-Pinazo, Cláudia Farinha, Luiz H. Lima, Ahmad M. Mansour, Antonio Marcello Casella, Lihteh Wu, Rufino Silva, Sami H. Uwaydat, Vishal Govindahari, J Fernando Arevalo, Jay Chhablani

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalBritish Journal of Ophthalmology
DOIs
StateAccepted/In press - Jan 1 2019

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Choroidal Neovascularization
Vascular Endothelial Growth Factors
Vascular Endothelial Growth Factor A
Visual Acuity
Optical Coherence Tomography
Membranes
Angioid Streaks
Multimodal Imaging
Therapeutics
Indocyanine Green
Fluorescein Angiography
Light Coagulation
Photochemotherapy
Macular Degeneration
Angiography
Lasers
Outcome Assessment (Health Care)
Injections

Keywords

  • age-related macular degeneration (AMD)
  • angioid streaks
  • anti-vascular endothelial growth factors (VEGF)
  • idiopathic intracranial hypertension (IIH)
  • inflammatory cnv
  • optic nerve head drusen
  • peripapillary choroidal neovascularisation (CNV)

ASJC Scopus subject areas

  • Ophthalmology
  • Sensory Systems
  • Cellular and Molecular Neuroscience

Cite this

One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation. / Singh, Sumit Randhir; Fung, Adrian T.; Fraser-Bell, Samantha; Lupidi, Marco; Mohan, Sashwanthi; Gabrielle, Pierre Henry; Zur, Dinah; Iglicki, Matias; M López-Corell, Paula; Gallego-Pinazo, Roberto; Farinha, Cláudia; Lima, Luiz H.; Mansour, Ahmad M.; Casella, Antonio Marcello; Wu, Lihteh; Silva, Rufino; Uwaydat, Sami H.; Govindahari, Vishal; Arevalo, J Fernando; Chhablani, Jay.

In: British Journal of Ophthalmology, 01.01.2019.

Research output: Contribution to journalArticle

Singh, SR, Fung, AT, Fraser-Bell, S, Lupidi, M, Mohan, S, Gabrielle, PH, Zur, D, Iglicki, M, M López-Corell, P, Gallego-Pinazo, R, Farinha, C, Lima, LH, Mansour, AM, Casella, AM, Wu, L, Silva, R, Uwaydat, SH, Govindahari, V, Arevalo, JF & Chhablani, J 2019, 'One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation', British Journal of Ophthalmology. https://doi.org/10.1136/bjophthalmol-2019-314542
Singh, Sumit Randhir ; Fung, Adrian T. ; Fraser-Bell, Samantha ; Lupidi, Marco ; Mohan, Sashwanthi ; Gabrielle, Pierre Henry ; Zur, Dinah ; Iglicki, Matias ; M López-Corell, Paula ; Gallego-Pinazo, Roberto ; Farinha, Cláudia ; Lima, Luiz H. ; Mansour, Ahmad M. ; Casella, Antonio Marcello ; Wu, Lihteh ; Silva, Rufino ; Uwaydat, Sami H. ; Govindahari, Vishal ; Arevalo, J Fernando ; Chhablani, Jay. / One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation. In: British Journal of Ophthalmology. 2019.
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abstract = "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-na{\"i}ve 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.",
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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, J Fernando

AU - Chhablani, Jay

PY - 2019/1/1

Y1 - 2019/1/1

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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