One-year outcomes of anti-vascular endothelial growth factor therapy in peripapillary choroidal neovascularisation

Sumit Randhir Singh, Adrian T. Fung, Samantha Fraser-Bell, Marco Lupidi, Sashwanthi Mohan, Pierre-Henry Gabrielle, Dinah Zur, Matias Iglicki, Paula M. López-Corell, Roberto Gallego-Pinazo, Cláudia Farinha, Luiz H. Lima, Ahmad M. Mansour, Antonio Marcello Casella, Lihteh Wu, Rufino Silva, Sami H. Uwaydat, Vishal Govindahari, Jose Fernando Arevalo, Jay Chhablani

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Abstract

Purpose: To report the visual and anatomical outcomes in eyes with peripapillary choroidal neovascularisation (CNV) through 12 months. Methods: This was a multicentre, retrospective, interventional case series which included treatment-naïve cases of peripapillary choroidal neovascular membrane (CNVM) with a minimum follow-up of 12 months. Multimodal imaging which comprised optical coherence tomography (OCT), fluorescein angiography and/or indocyanine green angiography was performed at baseline and follow-up visits. OCT parameters included central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and retinal and choroidal thickness at site of CNV. Patients were treated with anti-vascular endothelial growth factors (VEGF) on pro re nata protocol, photodynamic therapy, laser photocoagulation or a combination. Main outcome measures were change in best corrected visual acuity (BCVA) and OCT parameters. Results: A total of 77 eyes (74 patients; mean age: 61.9±21.8 years) with a mean disease duration of 9.2±14.1 months were included. BCVA improved significantly from 0.55±0.54 logMAR (20/70) at baseline to 0.29±0.39 logMAR (20/40) at 12 months (p<0.001) with a mean of 4.9±2.9 anti-VEGF injections. CMT, SFCT and retinal thickness at site of CNVM reduced significantly (p<0.001, <0.001 and 0.02, respectively) through 12 months. The most common disease aetiologies were neovascular age-related macular degeneration, and idiopathic, inflammatory and angioid streaks. Age (p=0.04) and baseline BCVA (p<0.001) were significant predictors of change in BCVA at 12 months. Conclusion: Peripapillary CNVM, though uncommon, is associated with diverse aetiologies. Anti-VEGF agents lead to significant visual acuity and anatomical improvement in these eyes over long term irrespective of the aetiology.

Original languageEnglish
Pages (from-to)678-683
Number of pages6
JournalBritish Journal of Ophthalmology
Volume104
Issue number5
Early online date10 Aug 2019
DOIs
Publication statusPublished - May 2020

Keywords

  • age-related macular degeneration (AMD)
  • angioid streaks
  • anti-vascular endothelial growth factors (VEGF)
  • idiopathic intracranial hypertension (IIH)
  • inflammatory cnv
  • optic nerve head drusen
  • peripapillary choroidal neovascularisation (CNV)

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