ABSTRACT
Objective To observe the long-term clinical efficacy of intravitreal ranibizumab (IVR) in patients with idiopathic choroidal neovascularization (ICNV),and to explore the indicators that affect curative effect.Methods A retrospective self-controlled study was performed.The clinical data of 61 ICNV patients (61 eyes) from January 2013 to May 2014 in the First Affiliated Hospital of Xi'an Jiaotong University were Collected.The best corrected visual acuity (BCVA),the central retinal thickness (CRT),the height of pigment epithelium detachment (PED) and the defect length of ellipsoidal zone (EZ) before and after treatment were analyzed,the baseline clinical indicators were compared among different IVR treatment times and ICNV types.Results The mean follow-up time was (41.5±4.6) months.The mean BCVA (LogMAR) were 0.59±0.32 and 0.17 ± 0.12,the mean CRT were (331.18±80.42) μm and (245.07±44.67) μm,the mean height of PED were (246.73±104.75) μm and (205.78±117.01) μm and the mean defect length of EZ were (2 315.10± 1 233.77) μm and (1 325.98± 1 157.30) μm before and after treatment,respectively,with significant differences between before and after treatment (all at P＜0.05).Fifty-three patients (86.89％) completed the treatment in the first year or within three times.The mean CRT and the height of PED in the IVR ≥ 3 times treatment group were significantly higher than those in the IVR 1 times treatment group (all at P＜0.05).There was no significant difference in the average treatment times among inferior lateral of macular fovea,side of macular fovea and outside of macular fovea (F =1.982,P ＞ 0.05).Conclusions IVR therapy for ICNV is well tolerated with an improvement in BCVA,CRT,height of PED and defect length of EZ.The majority of patients can complete the treatment within 1 year,and most patients can be cured within 3 times treatments.The number of treatments may be associated with the CRT and the height of PED at baseline.
ABSTRACT
Objetivo: presentar el caso de un paciente joven con neovascularización coroidea idiopática, con importante compromiso visual unilateral y que con la inyección intravítrea de aflibercept mensual, por tres meses, recuperó completamente la agudeza visual. Diseño: reporte de caso. Método: se realizó un estudio descriptivo tipo reporte de caso, mediante la recopilación de datos clínicos, estudios imagenológicos y valoraciones postoperatorias. Resultados: mejoría significativa de agudeza visual en paciente con neovascularización coroidea idiopática en ojo izquierdo posterior a tres inyecciones intravítreas de aflibercept mensual. El paciente mejoró de 20/400 a 20/20 al completar el esquema terapéutico. Conclusiones: el esquema de antiangiogénico resultó ser útil para el tratamiento de neovascularización coroidea idiopática en un paciente joven, logrando una recuperación visual y anatómica completa.
Objective: to present the case of a young patient with idiopathic choroidal neovascularization, with significant unilateral visual impairment. He fully recovered visual acuity by appliyng monthly intravitreal aflibercept, for three months. Design: case report. Method: a descriptive, case report study type was performed by collecting clinical data, imaging studies and postoperative evaluations. Results: Significant visual acuity improvement was obtained in the present patient with idiopathic choroidal neovascularization after three monthly intravitreal injections of aflibercept. The patient improved from 20/400 to 20/20 when treatment was completed. Conclusions: antiangiogenic schemev could be useful for the treatment of idiopathic choroidal neovascularization, achieving a complete visual and anatomical recovery.
Subject(s)
Choroidal Neovascularization , Visual Acuity , Angiogenesis Inhibitors/therapeutic useABSTRACT
Central exudative chorioretinopathy( CEC),also known as idiopathic choroidal neovascularization (ICN),was more common in middle-aged,appearing the isolated macular choroidal neovascularization lesions ( CNV ).CNV can cause macular hemorrhage,exudativeing and scarring and therefore affect the patient' s central vision.The etiology of CEC is below understanding,and the treatment aimed at CNV.The clinical management of CEC include photodynamic therapy ( PDT),the administration of antibody of vascular epithelial growth factor ( VEGF ),adrenal glucocorticoid drug,combined therapy,transpupillary thermotherapy (TTT),laser photocoagulation,ratiotherapy,surgery,Chinese traditional medicine and gene therapy.The various treating approaches and their mechanisms were reviewed.
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PURPOSE: To evaluate the correlation between lesional variation and visual outcome and natural course of idiopathic choroidal neovascularization (CNV) in the patient who had been treated with conservative treatment only. METHODS: Best corrected visual acuity (BCVA), fluorescein and indocyanine angiographic examination (FAG and ICGA) and comparative analyses were performed for twenty eyes diagnosed with subfoveal and juxtafoveal idiopathic CNV and the long-term (mean, 24.7 months) natural course was followed. RESULTS: Juxtafoveal CNV occurred in 12 eyes (60%) and final BCVA in 17 eyes (85%) improved over 1 line or remained unchanged. Minimal or no leakage of final FAG was shown in 12 eyes (60%). In final ICGA, dark rim was found in 16 eyes (80%), hyperfluorescent area in 12 (60%) and focal choroidal venous dilatation in 3 (15%). Juxtafoveal CNV had more favorable visual outcome than subfoveal CNV and the increased dark rim and decreased hyperfluorescent area in ICGA were significantly correlated with favorable visual outcome. CONCLUSIONS: Idiopathic CNV had a favorable visual outcome during long-term follow-up period with conservative treatment only.
Subject(s)
Humans , Choroid , Choroidal Neovascularization , Dilatation , Fluorescein , Follow-Up Studies , Visual AcuityABSTRACT
PURPOSE: To examine long-term natural history and visual prognosis of idiopathic subfoveal or juxtafoveal choroidal neovascularization (CNV). METHODS: A retrospective review of fourteen eyes diagnosed as idiopathic CNV at Seoul National University Hospital was done. Patients under 40 years old whose follow-up period of more than 36 months without treatments were included. Best corrected visual acuity (BCVA) with biomicroscopic and fluorescein angiographic examinations was measured at the initial and final visit. Clinical factors correlated with final visual acuity were analyzed. RESULTS: Mean age was 34 years ranged from 20 to 40 years and male to female ratio was 4 to 10. Patients were followed for a median of 45 months (range, 36-60 months). On initial examinations, BCVA in 14 eyes was over 0.15 with eight eyes under 0.5 and with six eyes over 0.6. Subfoveal CNV were in 12 eyes and juxtafoveal were in 2. All had the size smaller than 1DD (disc diameter). On the final visit, BCVA in 14 eyes was over 0.2 with three eyes under 0.5 and 11 eyes more than 0.6. Five eyes (36%) retained visual acuity and 8 eyes (57%) improved more than two lines. BCVA in one eye deteriorated two lines. In 6 eyes (42%), CNV was found to be regressed after the follow-up period. Initial visual acuity was significantly correlated with final visual acuity (p=0.013, Pearson correlation test). CONCLUSIONS: Idiopathic CNV has favorable visual prognosis and a tendency of spontaneous involution.