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K. Richani, C. N. Singh, D. M. Schlachter, C. Kim, J. E. Puklin, G. W. Abrams, T. H. Mahmoud; Effect of Anti-VEGF Therapy on Choroidal Neovascular Membrane Secondary to Causes Other Than Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2008;49(13):294.
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To determine the effects of anti-VEGF treatment on visual acuity (VA), fluorescein angiography (FA) and macular thickness in patients with active choroidal neovascular membranes (CNVM), not secondary to age-related macular degenerarion (AMD).
A retrospective study was conducted on patients presenting with active CNVM and treated with intravitreal anti-VEGF injections. Baseline and final VA , FA leakage area and macular thickness were measured. Statistical analysis was performed for all parameters.
Intravitreal anti-VEGF injections were administered in 18 eyes of 17 patients with active CNVM secondary to IPCV (n=4), myopia (n=3), idiopathic (n=2), APMPPE (n=2), angioid streaks (n=1), adult onset foveomacular pigment epithelial detachment (n=1), CSCR (n=1), histoplasmosis (n=1), toxoplasmosis (n=1), vitelliform maculopathy (n=1), and panuveitis (n=1). Mean age was 60±16.3 years (range 13-84 years); 12 females and 6 males. At presentation, subretinal hemorrhage was present in 9 eyes (50%). Prior treatment in the form of photodynamic therapy, cryotherapy, thermal laser, and steroid injection was administered in 12 of 18 eyes (66.6%). A total of 64 injections were given (61 Avastin, 1 Lucentis and 2 Macugen) with a mean of 3.6 injections per eye. Patients were followed for a mean of 7.1 months (range 1-21 months). There was no significant difference between initial and final VA (mean LogMAR 0.891±0.634 vs. 0.823±0.541, p=0.3). Initial FA demonstrated leakage in 100% of eyes [mean size 2.32±3.2.disc areas (DA) (4.1 mm2)] and final FA showed leakage in 44.45% eyes [mean size 1.3±3.8 DA (2.3mm2); p=0.03]. Similarly, optical coherence tomography showed a significant decrease in central subfield macular thickness (initial mean 309.5±95.3 µm vs. final mean 247.9±65.6µm; p=0.03).
Anti-VEGF monotherapy significantly reduced FA leakage and macular thickness in CNVM secondary to causes other than AMD. VA stabilization and not VA improvement could be explained by the higher frequency of other modalities of treatment received prior to the start of anti-VEGF therapy.
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