Analysis of Outcomes for Intravitreal Bevacizumab in the Treatment of Choroidal Neovascularization Secondary to Ocular Histoplasmosis

Cionni, Douglas A.; Lewis, Shawn; Petersen, Michael R.; Foster, Robert E.; Riemann, Christopher D.; Sisk, Robert A.; Hutchins, Robert K.; Miller, Daniel M.

doi:10.1016/j.ophtha.2011.08.032

Cited by 28 publications

(11 citation statements)

References 27 publications

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“…Cionni et al konnten an 150 Augen von 140 Patienten, die mit intravitrealen Injektionen in Verbindung mit oder ohne PDT behandelt wurden, nachweisen, dass hierdurch eine signifikante Visusverbesserung in einem Großteil der Patienten zu erreichen war. Dabei konnte kein signifikanter Unterschied in den Gruppen mit intravitrealen Injektionen alleine oder in Verbindung mit PDT hinsichtlich der Visusentwicklung gesehen werden [39].…”

Section: Ocular Histoplasmosis Syndrome -Ohs Und Presumed Ocular Histunclassified

Inflammatorische choroidale Neovaskularisationen

Winterhalter

Joussen

Pleyer

et al. 2012

Klin Monatsbl Augenheilkd

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Inflammation plays a key role in the induction of choroidal neovascular membranes (CNV). This explains why each form of posterior uveitis may lead to CNV formation. Diseases like presumed ocular histoplasmosis syndrome (POHS), multifocal choroiditis (MFC) or punctate inner choroidopathy (PIC) carry a high risk of CNV creation. Inflammatory processes mostly cause classical membranes. Because of the classical membrane form, smaller membrane size and the younger age of the patients' inflammatory membranes are often better treatable than membranes in AMD patients. In the times before VEGF inhibition inflammatory membranes were treated with argon laser coagulation and later with PDT. Nowadays better visual acuity results are achievable through VEGF inhibitor injections with or without PDT. This is proven by a few publications with greater numbers of patients because of the rarity of the diseases and several case reports in the literature. In addition to CNV treatment the control of intraocular inflammation should never be forgotten because it forms the leading CNV trigger.

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Section: Ocular Histoplasmosis Syndrome -Ohs Und Presumed Ocular Histunclassified

Inflammatorische choroidale Neovaskularisationen

Winterhalter

Joussen

Pleyer

et al. 2012

Klin Monatsbl Augenheilkd

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“…MFC tends to be a chronic disorder with, generally, a poorer visual prognosis. Some patients require systemic immunosuppression, while other treatments, such as photodynamic therapy and antivascular endothelial growth factor, are used to treat the resultant CNVM [34–36]. …”

Section: Resultsmentioning

confidence: 99%

Gender Differences in Birdshot Chorioretinopathy and the White Dot Syndromes: Do They Exist?

Lisa

2014

Journal of Ophthalmology

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Inflammatory conditions that affect the posterior pole are diverse. Specifically, birdshot chorioretinopathy and the white dot syndromes present with multiple white dots in the fundus. These diseases appear to affect similar age groups but there is question as to whether or not a difference exists between the genders. This review summarizes the current studies on birdshot chorioretinopathy and the white dot syndromes as they are related to gender, exploring the differences, if any, which may exist between prevalence, clinical presentation, and treatment response for these diseases. Though the specific etiology of these diseases remains unclear, future treatments may be guided as to how these diseases affect the sexes differently.

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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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Analysis of Outcomes for Intravitreal Bevacizumab in the Treatment of Choroidal Neovascularization Secondary to Ocular Histoplasmosis

Cited by 28 publications

References 27 publications

Inflammatorische choroidale Neovaskularisationen

Inflammatorische choroidale Neovaskularisationen

Gender Differences in Birdshot Chorioretinopathy and the White Dot Syndromes: Do They Exist?

Sonderformen choroidaler Neovaskularisationsmembranen

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