Photodynamic therapy for choroidal neovascularization in young adult patients

Mushtaq

Middle East Afr J Ophthalmol

2011

Purpose:To report long-term outcomes of the use of intravitreal bevacizumab in subjects with idiopathic choroidal neovascularization (ICNV).Materials and Methods:Six consecutive subjects with ICNV were included in this prospective study. All subjects received 1.25 mg intravitreal bevacizumab at diagnosis. A decrease in best corrected visual acuity (BCVA), presence of increased retinal edema or hemorrhage, increased retinal thickness on optical coherence tomography (OCT) or increased leakage documented by fluorescein angiography prompted further injections of bevacizumab.Results:The study cohort was comprised of 3 males and 3 females with a mean age of 31.17 years. Mean follow-up was 13.8 months (range, 8 months to 20 months). Following intravitreal bevacizumab injection, vision improved in 3 subjects, remained stable in 3 subjects and no patient lost visual acuity. The mean BCVA improved to logMAR 0.20 at final follow-up from baseline at 0.950 logMAR (P=0.031). The mean central macular thickness and central foveal thickness at the last postoperative visits were reduced from pre-treatment levels of 374.33 ± 146.52 and 347.16 ± 213.97 to 251.20±35.36 and 215.33 ± 43.94 μm, respectively. (P = 0.99 and P = 0.16, respectively). Four subjects required repeat treatments. The total number of repeat treatments was 4. Two subjects required no repeat injections, 3 subjects had 1 retreatment and one subject required 2 additional treatments. The injections were well tolerated by all the subjects, with no ocular or systemic adverse events.Conclusion:Intravitreal injection of 1.25 mg bevacizumab in patients with ICNV is effective in improving and stabilizing vision. Additional studies, particularly determination of optimal protocol for timing of re-injection are required to assess long-term effects.

Section: Discussionmentioning

confidence: 99%

Intravitreal bevacizumab as a primary treatment for idiopathic choroidal neovascularization

Mushtaq

Middle East Afr J Ophthalmol

2011

“…In patients with CNV younger than 50 years old, iCNV accounts for 17% of the total [8]. Treatments for iCNV include intravitreal and subtenon steroids, surgical removal, transpupillary thermotherapy, and photodynamic therapy with verteporfin [9, 10], which have different rates of success in improving visual acuity in patients with iCNV. Patients with iCNV respond better to anti-VEGF drugs than patients with age-related macular degeneration (AMD).…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of High-Dose Conbercept Treatment for Myopic Choroidal Neovascularization and Idiopathic Choroidal Neovascularization

et al. 2023

Introduction: To report 2-year outcomes of intravitreal injection of high-dose conbercept (1 mg 2+PRN scheme) for subjects with myopic choroidal neovascularization (mCNV) and idiopathic choroidal neovascularization (iCNV) by optical coherence tomography angi-ography (OCTA) follow-up. Methods: A total of 38 subjects (38 eyes) were enrolled in this retrospective study, which were divided into group A (mCNV, 20 subjects, 20 eyes) and group B (iCNV, 18 subjects,18 eyes). All subjects received 1.0 mg of conbercept intravitre-ally at diagnosis and again 35 days later. Additional conbercept injection was administered upon findings of decreased best-corrected visual acuity (BCVA); metamorphosis aggrava-tion, macular hemorrhage, or edema; increased central retinal thickness (CRT); or leakage observed by fluorescein angiography (FA). The BCVA, CRT, and CNV area of the two groups were evaluated at baseline and at 1, 2, 4, 6, 12, and 24 months after surgery. Results: The BCVA of group A improved from 0.31 ±0.16 logMAR at baseline to 0.12 ± 0.03logMAR at the final follow-up (P < 0.001), while in group B the corresponding im-provement was from 0.33 ± 0.16logMAR at baseline to 0.12 ± 0.03logMAR at the final fol-low-up (P < 0.001). Visual acuity improved in 17 subjects in group A and 15 in group B, while it remained stable in 3 subjects each in groups A and B. CRT decreased from 311.83 ± 30.95 μm in group A and 351.17 ± 37.09 μm in group B pre-operation to 229.56 ± 5.75 μm and 227.67 ± 4.98 μm at 24 months follow-up, respectively (P < 0.001 in groups A and B). Metamorphopsia was improved in subjects in groups A and B. CNV had disappeared in the two groups at the last postoperative visit. The BCVA, CRT, and CNV area were no statisti-cal differences between the two groups at 6, 12, and 24 months follow-up (p > 0.05). Con-clusion: Intravitreal injection of conbercept (1 mg 2+PRN scheme) is effective for treating patients with mCNV or iCNV, which can improve and stabilize vision as well as dramatical-ly alleviate metamorphopsia.

“…In recent years, the anti-vascular endothelial growth factor (VEGF) agents used in patients with mCNV have demonstrated considerable success in visual acuity gains and have led to an improvement in the patients' quality of life ( 7 ). Intravitreal and subtenon steroids, photodynamic therapy, transpupillary thermotherapy and various other treatments have had varying degrees of success in preventing visual loss in patients with CNV ( 8 , 9 ). Due to the good efficacy of anti-VEGF biological agents, including bevacizumab, ranibizumab and aflibercept, these have been proposed as a first-line treatment for mCNV ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

High‑dose aflibercept injection has striking effects on myopic choroidal neovascularization

et al. 2023

The aim of the present study was to evaluate the 1-year outcomes of a high-dose aflibercept injection [4 mg 2+ pro re nata (PRN) scheme] for individuals with myopic choroidal neovascularization (mCNV) through optical coherence tomography (OCT) follow-ups. A total of 16 consecutive patients (7 males and 9 females; sixteen eyes) with mCNV were enrolled in this retrospective study. The mean age was 30.5±3.35 years and mean spherical equivalent was -7.31±0.90 D. Subjects received 4 mg aflibercept intravitreal injection on the day of diagnosis and 35 days later. Further injections of aflibercept were required when the following were detected by OCT and fluorescein angiography: i) Decrease in best corrected visual acuity (BCVA); ii) aggravation of metamorphopsia; iii) macular oedema; iv) macular haemorrhage; v) increase in retinal thickness; and vi) leakage. Ophthalmic examination and OCT were performed at the baseline, as well as at 1, 2, 4, 6, 8, 10 and 12 months after the initial aflibercept injection. BCVA and central retinal thickness (CRT) were evaluated at each follow-up. The results showed that the vision of all subjects improved following the aflibercept intravitreal injection. The mean BCVA improved from 0.35±0.15 logarithm of the minimal angle of resolution (logMAR) at the baseline to 0.12±0.05 logMAR at final follow-up (P<0.05). A reduction in metamorphopsia was observed and the mean CRT was reduced from 345.38±34.69 µm of pre-treatment levels to 222.75±8.98 µm at the last postoperative visit (P<0.05). The mean number of injections in the present study was 2.13±0.5. Out of all patients, 13 received two injections and 3 subjects received three injections. The mean follow-up was 13.41±1.17 months. Based on the outcomes, it was found that an intravitreal injection of high-dose aflibercept (4 mg 2+PRN scheme) is effective for vision improvement and stabilization. In addition, it also significantly alleviated metamorphopsia and reduced the CRT in patients treated with mCNV. During the follow-up, the eyesight of the patients was stable.