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Teresa Barth, Maria-Andreea Gamulescu, Horst Helbig; Intravitreal antiangiogenic treatment for choroidal neovascularization secondary to punctate inner choroidopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2132.
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© ARVO (1962-2015); The Authors (2016-present)
Choroidal neovascularization (CNV) is a frequent complication of punctate inner choroidopathy (PIC). We retrospectively assessed clinical features and outcome of patients receiving intravitreal antiangiogenic injections (Bevacizumab or Ranibizumab) for PIC-related CNV.
A total of 13 eyes of 13 patients diagnosed with CNV secondary to PIC between 2006 and 2015 that underwent intravitreal antiangiogenic treatment were assessed. PIC-related fundus changes and CNV were identified by ophthalmoscopy and confirmed by fundus autofluorescence and fundus fluorescein angiography (FFA). Best corrected logMAR visual acuity (BCVA) was assessed by conversion of Snellen's chart values. Main clinical parameters included BCVA before and after treatment, location of CNV, regression of CNV on funduscopy and FFA as well as type of antiangiogenic drug and number of intravitreal injections.
9 women and 4 men with mean age of 35 years (SD 15, range 16-55 years) presented with CNV secondary to PIC in the mentioned period. 7 eyes showed subfoveal and 6 eyes juxta- or extrafoveal CNV localization. 11 eyes received intravitreal anti-VEGF (vascular endothelial growth factor) injections as primary treatment for CNV. 2 eyes were treated secondarily with intravitreal anti-VEGF after initial treatment with photodynamic therapy (PDT) had failed. Mean follow-up was 3.2 years (SD 2.44). On average, 4 injections (SD 3.7, range 1-12) were given. 5 eyes needed only a single anti-VEGF injection. 10 eyes were treated with Bevacizumab, 2 eyes with Ranibizumab and one eye received both intravitreal drugs. Regression of CNV on funduscopy and FFA was noted in all eyes. Mean logMAR BCVA at baseline and last follow-up was 0.3 (SD 0.34) and 0.4 (SD 0.45), respectively. In 4 eyes BCVA improved, 6 eyes remained stable, and 3 eyes showed decline of vision.
CNV development is a common ocular complication of PIC. Since the establishment of intravitreal anti-VEGF therapy for CNV, laser coagulation and PDT have lost significance. Intravitreal antiangiogenic substances seem to be safe and effective for PIC-related CNV. However, multiple intravitreal injections are frequently necessary for stabilization.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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