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Jonathan Benesty, Sarah Mrejen, Oudy Semoun, Claire Monin, Zineb Lazrak, Michel Paques, Jose A. Sahel, Jr.; Intravitreal anti-VEGF Injections Therapy In Choroidal Neovascularization Secondary To Choroidal Osteoma: About 5 Cases. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4939.
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To determine the efficacy and safety of intravitreal anti-VEGF injections in eyes with choroidal neovascularization (CNV) secondary to choroidal osteoma (CO).
Retrospective analysis of eyes of consecutive patients with CNV secondary to CO. Each patient underwent a complete examination including visual acuity, fundus exam, B-scan ultrasound, fluorescein angiography and spectral-domain OCT (SD-OCT) at baseline. Follow-up examinations included visual acuity, fundus exam and SD-OCT. CO was defined on fundus exam and B-scan ultrasound criteria. CNV diagnosis was based on fluorescein angiography analysis. We defined intravitreal anti-VEGF injections efficacy primarily based on the regression of hemorrhages (assessed on fundus exam), and signs of exudation (subretinal fluid (SRF) and/or intra-retinal edema assessed on spectral-domain-OCT) secondary to CNV. The secondary outcome was visual acuity.
There were five eyes of four patients who had a mean age of 22 years, 2 were female. Initial fluorescein angiography exam revealed visible or classic CNV in all cases. Initially, subretinal hemorrhages were found on fundus exam in 3 eyes, SD-OCT showed SRF in all eyes and intraretinal edema in 1 eye. Mean follow-up was 12 months (range 7-16). Complete resolution of hemorrhages and exudation were achieved in all after mean number of injections of 2.8 (range one to seven). In case one, visual acuity improved from 0.05 to 0.8 after one intravitreal anti-VEGF injection. In case 2, visual acuity improved from 0.5 to 0.8 after 4 injections. In case three, symptoms have been going on for months before the onset of treatment, visual acuity improved from hand motions to 0.2 after seven injections. In case 4, with bilateral CNV, visual acuity improved respectively from 0.5 to 1.0 in the right eye after one injection and from 0.05 to 0.8 in the left eye after one injection. Two eyes had a recurrence after initial complete resolution of exudation related to CNV. There was no local nor systemic adverse event.
Intravitreal anti-VEGF injections allowed to achieve complete resolution of exudation related to CNV secondary to CO and to improve visual acuity in all eyes. Intravitreal anti-VEGF injections might be a safe and efficient alternative to photodynamic therapy in the treatment of CNV associated with CO.
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