Purpose:
To determine the response of peripapillary choroidal neovascularization (CNV) to intravitreal injection of antibodies to vascular endothelial growth factor (anti-VEGF).
Methods:
Retrospective case series. A chart review was conducted to identify patients with peripapillary CNV that did not involve the fovea and received only anti-VEGF treatment. The demographic data, visual acuities, complications, number of injections and remission periods were reviewed. Recurrent subretinal or intraretinal fluid on spectral domain OCT was the indication for reinjection.
Results:
21 eyes from 20 patients were found to have peripapillary CNV, including 14 eyes with AMD, 4 eyes with presumed ocular histoplasmosis, 1 eye with choroidal rupture, and 2 eyes with unknown etiology. 2/21 eyes were treated with a combination of bevacizumab and ranibizumab and 19/21 eyes received only bevacizumab. Patients received an average of 5.95 injections (range 2-18) for each involved eye. An average of 2.9 (range 1-9) intravitreal injections were required to control the lesions. 18/21 eyes had lesions that went into remission. 14/18 eyes remained in remission for an average of 8.4 months (range 1-31). 4/18 eyes had recurrent fluid following an average 6.25 month treatment interval (range 3-8). The pre-injection visual acuity averaged 20/40 (range of 20/20-20/100). The post-injection visually acuity averaged 20/30 (range 20/15-20/60). The mean follow up was 16.75 months (range 3-58 months). There were no adverse events related to treatment.
Conclusions:
Anti-VEGF therapy is effective for peripapillary CNV with good visual outcomes, but requires careful monitoring for recurrence.
Keywords: choroid: neovascularization • choroid • vascular endothelial growth factor