Abstract
Purpose :
To evaluate the clinical course of peripapillary choroidal neovascularization (PP CNV), the associated conditions and its response to the treatment modalities.
Methods :
We reviewed the chart of patients who were diagnosed with PP CNV in UPMC Eye Center over the past 12 years. The demographics, BCVA at presentation and the last follow up visits, associated clinical findings in both eyes, the fundus photographs, fluorescein and ICG angiograms, Optical Coherence Tomography images, and the applied treatment modalities were the main parameters evaluated in this cases series.
Results :
Twenty six eyes of 22 patients with the clinical picture of PP CNV and confirmed diagnosis with fluorescein and/or ICG angiography were included in this report. The mean age at the diagnosis was 69 years (range: 17-92 years). The mean follow up period was 44.5 months with the range of 3 to 144 months. The mean refractive error was +1.33D (SE), with the range of -12.00 to +7.50D; 77% (20 eyes) were hyperopic.
The associated ocular conditions were 10 (38.5%) Polypoidal Choroidal Vasculopathy (PCV), 8 (23%) typical Age-related Macular Degeneration, 2 optic nerve drusen, 2 optic nerve coloboma, one choroidal fold, one choroidal nevus, one lacquer crack (high myopia), and one angioid streaks. Two eyes had no determined associated pathology.
Eleven eyes (42.3%) underwent intravitreal anti-VEGF injections for treatment. Other treatment modalities were Photodynamic Therapy, Transpupillary Thermotherapy, laser photocoagulation or a combination of the mentioned therapies and anti-VEGF injections. Totally 19 eyes(73%) received anti-VEGF therapy with the average of 14 injections (range: 1-42).
The mean BCVA at presentation was 20/60. At last follow up visit, whether in the eyes treated or not, the mean BCVA was 20/80.13 of 21eyes (62%) which underwent a mode of treatment had a stabilized or improved vision at the final visit. In this group of patients the BCVA improved from 20/100 to 20/60 (P<0.05).
Conclusions :
Interestingly, in our series PCV was the most common condition associated with PP CNV. The majority of patients who underwent treatment had stable or improved visual outcome (62%). This improvement in visual outcome was statistically significant. However, to determine the precise effect of treatment and the best modality, prospective studies with larger sample size are recommended.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.