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, Jose 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)
Pages (from-to)678-683
Number of pages6
JournalBritish Journal of Ophthalmology
Volume104
Issue number5
DOIs
StatePublished - May 1 2020

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

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  • Cite this

    Singh, S. R., Fung, A. T., Fraser-Bell, S., Lupidi, M., Mohan, S., Gabrielle, P. H., Zur, D., Iglicki, M., M López-Corell, P., Gallego-Pinazo, R., Farinha, C., Lima, L. H., Mansour, A. M., Casella, A. M., Wu, L., Silva, R., Uwaydat, S. H., Govindahari, V., Arevalo, J. F., & Chhablani, J. (2020). One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation. British Journal of Ophthalmology, 104(5), 678-683. https://doi.org/10.1136/bjophthalmol-2019-314542