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E Farvili, P Walter, RA Widder, HD Ayertey, U Schraermeyer, B Kirchhof, R Brunner; The Treatment of Idiopathic Subfoveal Choroidal Neovascularisation (CNV) With 7 S Immunoglobulins . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2522.
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Purpose: The pathogenesis of idiopathic CNV is still under debate but a common feature in these patients are inflammatory changes in the affected tissues. Therefore the application of an immunomodulatory therapy may have a beneficial effect. This study investigates the influence of a repetitive treatment with intravenous immunoglobulins in patients with idiopathic CNV. Methods: 10 patients with an idiopathic CNV were treated over a mean period of 18 month by repetitive infusion of intravenous 7 S immunoglobulins. The mean age of the patients was 38,5 years. The treatment was applied every 3-6 weeks on an individual base. A total dose of 50-100 g was administered during each treatment cycle. Clinical endpoint of the study was visual acuity measured by ETDRS charts. Results: The treatment with intravenous immunoglobulins was well tolerated by all patients. Significant side effects did not occur. 9/10 patients showed an improvement of visual acuity. The mean improvement was 2.6 lines (p<0.01) after three and 3.2 lines (p=0.02) after 18 months. According to the flourescein angiography a partial involution and scaring of the CNV was observed. Conclusion: This study demonstrates the beneficial effect of intravenous immunoglobulins on the natural course of idiopathic CNV. The repetitive treatment led to functional and morphological improvements. Our hypothesis is that the occurence of idiopathic CNV is related to immunological changes in the affected tissues which can be controlled with an immunomodulatory treatment as applied.
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