Treating peripapillary choroidal neovascular membranes: a review of the evidence

Abstract

Peripapillary choroidal neovascular membranes (PCNM) are defined as a collection of new choroidal blood vessels, any portion of which lies within one disc diameter of the nerve head. There are two types of PCNM, and correct pre-interventional identification of growth site has been shown to stratify the chance of visual improvement following therapy. Clinical manifestations occur only where the membrane extends over the macula, if the vessels haemorrhage into the subretinal space or fluid exudation occurs within the macula. This review provides an update and overview on the diverse range of current treatment studies and strategies being used in present clinical ophthalmic practice.

Choroidal neovascular membrane in paediatric patients: clinical characteristics and outcomes

“…The lesions were active in 55.5% of cases. Regardless of size and aetiology, the natural course of untreated PPCNVM has been reported to be variable, ranging from spontaneous involution to fulminant enlargement towards the fovea 14. In our series, one eye regressed spontaneously without affecting the vision; however, neither the fovea nor the juxtafoveal region was involved.…”

Diagnostic Challenges in Inflammatory Choroidal Neovascular Membranes

“…If the membranes are treated before this stage, they have better visual outcomes. 11 If left untreated, their natural history suggests a very poor outcome, with about one-quarter of them achieving 20/500 visual acuity or worse after 3 years. 12 The majority of inflammatory CNVMs occur during the time of, or after the onset of, uveitis.…”

“…Peripapillary CNVM was defined as a CNVM, any portion of which was within one disc diameter of the optic nerve head. 11 The FFA features were noted as classic or occult CNVM, and transmission defects corresponding to the scar of CNVM. The OCT findings included subretinal or intraretinal fluid, cystoid macular edema (CME), epiretinal membrane (ERM), or a sub-retinal pigment epithelium (RPE) membrane.…”

Photodynamic therapy: current role in the treatment of chorioretinal conditions

“…The current treatment modalities comprise vPDT therapy or anti-VEGF therapy. 72 vPDT therapy usually achieves PP-CNV regression following 1 or 2 treatments with only a small risk of an adverse effect (Figure 1 d.1-d.5). 73,74 Anti-VEGF therapy is also effective but may require multiple injections to achieve PP-CNV regression.…”