Treatment of CNV secondary to presumed ocular histoplasmosis with intravitreal aflibercept 2.0 mg injection

Walia, Harpreet S.; Shah, Gaurav K.; Blinder, Kevin J.

doi:10.1016/j.jcjo.2015.11.007

Cited by 12 publications

(3 citation statements)

References 17 publications

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“…Her visual acuity improving from Snellen 20/70 to 20/20 over a span of 6 months, with only 3 monthly injections initiated at her presentation. Our experience was consistent with that of published case series, which showed intravitreal antivascular endothelial growth factors (VEGF) injections to be effective for POHS related CNV; on average, patients' visual acuity improved requiring relatively few treatments (range 2.6 to 7 injections per patient per year) [ 1 – 4 ] as compared to neovascular age-related macular degeneration (AMD).…”

Section: Discussionsupporting

confidence: 87%

Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

Liu

Zhang

Wenick

2018

Case Reports in Ophthalmological Medicine

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A 37-year-old Caucasian woman presented with acute decrease in central vision in her right eye and was found to have subfoveal choroidal neovascularization (CNV) due to presumed ocular histoplasmosis syndrome (POHS). Her visual acuity improved from 20/70 to 20/20 at her 6-month follow-up, after 3 consecutive monthly intravitreal bevacizumab injections were initiated at her first visit. Although no CNV activity was seen on fluorescein angiography (FA) or spectral-domain optical coherence tomography (SD-OCT) at her 2-month, 4-month, and 6-month follow-up visits, persistent flow in the CNV lesion was detected on optical coherence tomography angiography (OCTA). OCTA shows persistent vascular flow as well as changes in vascular flow in CNV lesions associated with POHS, indicating the continued presence of patent vessels and changes in these CNV lesions, even when traditional imaging of the lesion with OCT and FA indicates stability of the lesion with no disease activity. Additional cases with longitudinal follow-up are needed to assess how OCTA should be incorporated into clinical practice.

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Section: Discussionsupporting

confidence: 87%

Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

Liu

Zhang

Wenick

2018

Case Reports in Ophthalmological Medicine

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“…63 The VEGF inhibitor aflibercept was shown to be effective and safe for patients with POHS in a masked openlabel study; the 5 patients with POHS experienced improvement from baseline in VA and a decrease from baseline in central subfoveal thickness, and reported no systemic or ocular AEs at 12 months. 64 Results of a Phase 1 study that included 9 patients with POHS indicated that more than half of patients overall experienced improvement in visual acuity following monthly intravitreal ranibizumab injections (66.7% had ≥15 letter improvement at both 6 and 12 months) or 3 monthly intravitreal ranibizumab injections followed by treatment as needed (64.3% and 57.1% had ≥15 letter improvement at 6 and 12 months, respectively). 65 A long-term, retrospective study reported that VEGF inhibitor alone or in combination with vPDT was effective for improving VA for the first few years of a 10-year period, with no significant difference between treatment modalities.…”

Section: Dovepressmentioning

confidence: 99%

Verteporfin Photodynamic Therapy for the Treatment of Chorioretinal Conditions: A Narrative Review

Garg,

Hadziahmetovic

2024

OPTH

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“…Auch für Aflibercept [28][29][30] und Bevacizumab [31][32][33][34] sind zahlreiche (z. T. prospektive) Fallserien sowie Kasuistiken mit gutem Ansprechen bei geringer Injektionsanzahl publiziert. Unabhängig davon sind gegenwärtig alle Anti-VEGF-Präparate für sekundäre CNV-Membranen, abgesehen von denen bei einer pathologischen Myopie, im Off-Label-Use.…”

Section: Sekundäre Neovaskularisationsmembranenunclassified

Sonderformen choroidaler Neovaskularisationsmembranen

Sandner

2017

Klin Monatsbl Augenheilkd

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Choroidal neovascularisation (CNV) in the context of exsudative age-related macular degeneration (nAMD) can be divided into type 1 (occult) and type 2 (classical) membranes. Retinal angiomatous proliferation (RAP) or polypoidal choroidal vasculopathy (PCV) are "rare subtypes" of chorioretinal neovascularisation and are distinguished by their distinct morphology and the sometimes worse response to therapy. Chorioretinal anastomosis, severe exsudates with serosanguinous pigment epithelial detachment and, in PCV, orange-red lesions in the papillomacular bundle can be diagnostic. Indocyanine green angiography (ICGA) is considered the gold standard for diagnosis of PCV and delivers important information for RAP too. Typical characteristics of PCV include foci of hyperfluoresence, with pulsatile filling in the early phase. This characterises choroidal polypoidal lesions, often in connection with an abnormal choroidal vascular network. In RAP, typical retino-retinal anastomosis can be identified, in particular in areas with pigment epithelial detachment. Optical coherence tomography (OCT) can complement diagnostic testing. In cases of RAP, early therapy initiation with intravitreal anti-VEGF is crucial for the prognosis of visual acuity. PCV can exhibit spontaneous regression. In active disease, photodynamic therapy (PDT) is efficient in the closure of PCV polyps. In association with CNV, it makes sense to combine PDT and intravitreal anti-VEGF medication. In spite of the initial increase in visual acuity, this state is normally "only" stabilised in the long term. In patients with idiopathic secondary CNV membranes (high myopia, post-inflammatory, post-traumatic changes or in hereditary connective tissue diseases), small "classical" type 2 membranes are mostly involved. Hence, these are strictly speaking not directly rare subtypes. Nevertheless, these patients are mostly younger, with less protracted illness and limited available regeneration ability of the retinal pigment epithelium (RPE): they may therefore differ favourably from the courses with nAMD, with earlier inactivation and with fewer required anti-VEGF injections. CNV with angioid streaks are a special case in this group. Unfortunately, these lesions have a recurrent, protracted and, in the end, mostly frustrating course.

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Treatment of CNV secondary to presumed ocular histoplasmosis with intravitreal aflibercept 2.0 mg injection

Cited by 12 publications

References 17 publications

Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

Evolution of Choroidal Neovascularization due to Presumed Ocular Histoplasmosis Syndrome on Multimodal Imaging including Optical Coherence Tomography Angiography

Verteporfin Photodynamic Therapy for the Treatment of Chorioretinal Conditions: A Narrative Review

Sonderformen choroidaler Neovaskularisationsmembranen

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