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Leonidas Zografos, Aude Ambresin, Ann SCHALENBOURG; Iris Neovascularisation Remodelling Under Intravitreal Vegf Suppression. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2957.
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The aim of this prospective study was to analyse the benefit of intravitreal (IV) anti VEGF injection on iris neovascularisation (NVI) secondary to proton beam irradiation of posterior uveal malignant melanomas (MM)
All eyes presenting secondary NVI were consecutively included. Iris fluorescein angiography (FA) was performed at baseline and at each follow up (FU) visit. Based on FA, NVI was classified as diffuse, sectorial, pupillary and tufts. The degree of dye leakage was quantified. Retreatment was applied in case of persistent leaking new vessels.
From 2006 to 2010,920 eyes received proton therapy for MM. 69 eyes presented secondary NVI. At baseline, 43% were diffuse and dye leakage was marked in 55%. Sectorial iris ischemia was present in 64% of cases. During the follow up period, the numbers of injections ranged from 1-6. Regression of NVI was observed in 68% of eyes and 67% of eyes showed reduction of dye diffusion. Over time, remodelling of the ischemic iris with progressive revascularisation occurred in 32% of eyes and 50% of eyes showed maturation of the NVI. Eye retention probability was 96%.
In growth of well shaped new vessels in the ischemic zone and maturation of the NVI suggest that organised angiogenesis can occur under pharmacologically modulated VEGF expression.Anti VEGF injections is a promising therapeutic approach of NVI secondary to proton beam irradiation achieving a high rate of eye retention
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