Abstract
Abstract: :
Purpose:The development of subretinal neovascular membranes (SRNMs) is a well-known complication of posterior intraocular inflammatory diseases. The purpose of the present investigation was to evaluate, in a population of 643 patients with uveitis, the proportion of SRNM formation and analyze the characteristics of the disease. Methods:The charts of patients examined between January 1995 and November 2001, in the uveitis consultation of La Source Eye Center, were reviewed. Patients with SRNMs had, in addition to routine ophthalmological examination, dual fluorescein and indocyanine green angiographies performed. The main parameters taken in consideration were the initial uveitic pathology, the type and localisation of SRNM and the visual outcome of the treatement subgroups. Results:Twelve patients (1.8%), predominantly women (84%), presented SRNM complication of their uveitis consequent to suspected (n=2) and confirmed (n=3) sarcoid chorioretinitis, suspected tuberculous chorioretinitis (n=3), toxoplasmosis chorioretinitis (n=1), multifocal choroiditis (n=2) and sympathetic ophtalmia (n=1). SRNMs were classical in eleven cases, occult in one case, retrofoveolar in eight cases, peripapillary in three cases and parafoveolar in one case. Treatment consisted of corticosteroids (CS) alone in six cases, Photodynamic therapy (PDT) and CS in three cases, PDT alone in one case, CS and classical laser (CL) in one case and Transpupillary thermodynamic therapy (TTT) and CS in one case. Vision improved (gain of two lines or more) in two cases treated with CS alone, in two cases treated with PDT and CS, in one case treated with PDT alone and in one case treated with TTT and CS. Vision was maintained (same line ± one line) in two cases treated with CS alone, in one case treated with PDT and CS and in one case treated with CS and CL. Vision decreased (loss of two lines or more) in two cases treated with CS alone. Conclusion:Subretinal neovascular membranes represent a rare complication of uveitis that tend, in our study, to occur mainly in granulomatous types of intraocular inflammation. They are mostly classical and have a relatively favorable outcome. Photodynamic therapy alone or in combination with CS seems to be a promising treatment modality.
Keywords: 346 choroid: neovascularization • 570 retinochoroiditis