Abstract
Purpose: :
Is visual prognosis of the rare classic choroidal newvessels (CNV) improved by intravitreal (IVT) antiVEGF treatment ?
Methods: :
In this one year prospective study, we have analysed ETDRS visual acuity (VA), fluorescein angiography and OCT of classic CNVs, before and 4 to 6 weeks after each ranibizumab (6 eyes) or bevacizumab (6 eyes) IVT repeated after 2 initial sessions in case of persistence or recurrence.
Results: :
Mean initial VA was 0,26 and final VA 0,20. Classic CNVs appeared occluded after first anti VEGF IVT in 3 eyes, after the second injection in 7 eyes and after third injection in 2 eyes. CNV recurrence occurred in 75% of cases after a mean evolution of 4 months. CNV scar appeared rapidly hyperpigmented in all cases with overlying retinal thinning on OCT and decreased vision of one or more ETDRS lines and central scotoma in 5 eyes. VA was increased in 5 eyes and stable in 2 eyes. In 2 cases a pseudomacular hole progressed to full thickness atrophic hole with a 1 and 4 lines VA decrease.
Conclusions: :
Anti VEGFs therefore improve visual prognosis of classic CNVs but an hyperpigmented scar and retraction of pseudomacular hole can induce VA decrease.
Keywords: age-related macular degeneration • choroid: neovascularization • vascular endothelial growth factor