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V. Le Tien, C. Fardeau, T. Tran, I. Meunier, B. Bodaghi, G. Soubrane, P. Le Hoang; Inflammatory Choroidal Neovascularization: Long–Term Outcome After Combination of Immunosuppressive Treatment and Local Laser Photocoagulation or Photodynamic Therapy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):380.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate long–term visual outcome after association of immunosuppressive therapy with laser photocoagulation for extrafoveal inflammatory choroidal neovascularization (CNV) or photodynamic therapy (PDT) for subfoveal inflammatory CNV.
A total of 22 consecutive patients (22 eyes) with active CNV secondary to posterior uveitis were restropectively reviewed. Laser photocoagulation was performed when the CNV was extrafoveal (7 eyes). Patients with subfoveal localization underwent PDT with verteporfin (15 eyes). All patients received immunosuppressive systemic treatment (corticosteroid, ciclosporin, azathioprin) and/or intravitreal triamcinolone. Etiologies included: multifocal choroiditis (4), toxoplasmosis (3), Birdshot choroidoretinopathy (2), tuberculosis (2), sarcoidosis (2), punctate inner choroidopathy (2), serpiginous choroiditis (2),Vogt Koyanagi Harada disease (1) and idiopathic posterior uveitis (3).Visual acuity, fluorescein and ICG angiography and OCT findings were evaluated.
Mean follow–up was 34.6 months for extrafoveal CNV (range 8–96) and 15.7 months for subfoveal CNV (range 8–36). In the group with extrafoveal localization, visual improvement of at least 2 lines was obtained in 6 out of 7 eyes (86 %), and visual stabilization was obtained in 1 out of 7 eyes (14 %) at the end of the follow–up period. In the group with sub foveal localization, visual acuity improved (2 lines or more) in 9 out of 15 eyes (60 %) and remained stable in 5 out of 15 eyes (33 %) at the end of follow–up period. Visual acuity decreased for one patient (7 %) with a lost of 2 lines at the last follow–up. A mean of 1.5 (range 1–3) PDT was performed. No side effects were observed.
The combination of immunosuppressive therapy and local laser treatment appears to be a therapeutic option for extrafoveal inflammatory CNV. PDT could be beneficial for visual prognostic in subfoveal inflammatory CNV, if applied in association with an efficient immunosuppressive treatment.
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