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Ehab A. Abdelkader, Noemi Lois, Neil W. Scott; Epidemiology Of Angioid Streaks-Associated Cnv In The United Kingdom. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2147.
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To determine the incidence of angioid streaks-associated choroidal neovascular membranes (CNV) in the UK and to provide epidemiological data, clinical characteristics, treatments used and short-term outcomes.
Cases were identified through the British Ophthalmological Surveillance Unit (BOSU), supported by the UK Royal College of Ophthalmologists. Ophthalmologists actively reporting cases were sent questionnaires at baseline (at the time they reported a case) and 12 months thereafter.
Between January 2009 and March 2010, 44 cases of angioid streaks-associated CNV were reported to BOSU giving an annual incidence of 0.057 (95% CI: 0.040-0.074) per 100,000 population. Of these, 35 baseline questionnaires were completed by the reporting ophthalmologists and received by the investigators. There were 19 males and 14 females (n = 2 gender not available), with a mean age of 47 years (range; 24-62 years). The mean LogMAR visual acuity at baseline was 0.51 (SD & range, 0.54 & -0.1 to 2). The Angioid streaks were associated with pseudoxanthoma elasticum in 23 cases (66%), sickle cell disease in 1 (0.03%) and idiopathic in 11 (31%). Family history of angioid streaks was present in 6 out of the 35 cases (17%). The angioid streaks-associated CNV was sub-foveal in 18 cases, juxta-foveal in 9, and extra-foveal in 8. Treatments included bevacizumab (n=5), ranibizumab (n=14) and argon laser photocoagulation of the CNV (n=3). At one year (follow-up data is currently available in 22 cases; should be completed by March 2011) the mean LogMAR visual acuity was 0.8 (SD & range, 0.68 & 0.0 to 2); a statistically significant reduction in VA from baseline of -0.37 (P=0.01, 95% confidence interval of -0.66 to -0.9, paired t-test). New CNV developed in the same eye in 14% of cases (n=3) and in the fellow eye in 0.05% (n=1) during the follow-up. No complications related to the treatment were reported. At last follow up, 27% of CNVs remained active despite treatment (n=6); 32% of cases were still undergoing therapy.
This study is the first population based prospective study evaluating the incidence of angioid streaks-associated CNV. Despite new treatments for CNV, the visual outcome of patients with this disorder remains guarded.
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