Bilateral Cnv Associated with Optic Nerve Drusen Treated with Photodynamic Therapy with Verteporfin

Silva, R.; Torrent, Teresa; Loureiro, Renata Ruoco; Travassos, António; Abreu, J. R. Faria de

doi:10.1177/112067210401400512

Cited by 23 publications

(9 citation statements)

References 4 publications

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“…Some investigators have advocated the use of photodynamic therapy with verteporfin as safe and effective for the treatment of CNV associated with symptomatic ONHD 13–15…”

Section: Discussionmentioning

confidence: 99%

Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy

Delás¹,

Almudí²,

Carreras³

et al. 2012

OPTH

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ObjectiveTo report a good clinical outcome in a patient with bilateral choroidal neovascularization (CNV) associated with optic nerve head drusen (ONHD) treated with intravitreal ranibizumab injection.MethodsA 12-year-old girl was referred for loss of right eye vision detected in a routine check-up. Best-corrected visual acuity (BCVA) was hand movements in the right eye and 0.9 in the left eye. Funduscopy revealed the presence of superficial and buried bilateral ONHD, which was confirmed by ultrasonography and computed tomography, and the study was completed with perimetry. The presence of bilateral CNV, active in the right eye, was observed and subsequently confirmed using fluorescein angiography and optical coherence tomography.ResultsTreatment with two consecutive injections of intravitreal ranibizumab resulted in inactivation of the neovascular membrane with subretinal fluid reabsorption and improved right eye BCVA. After 12 months’ follow-up, this was 20/60 and stable.ConclusionAlthough there are no published studies of safety in children, antiangiogenic therapy for CNV secondary to ONHD may be useful and safe. A search of the literature produced only one previously reported case of ONHD-associated CNV treated with antivascular endothelial growth factor alone.

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“…Some investigators have advocated the use of photodynamic therapy with verteporfin as safe and effective for the treatment of CNV associated with symptomatic ONHD 13–15…”

Section: Discussionmentioning

confidence: 99%

Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy

Delás¹,

Almudí²,

Carreras³

et al. 2012

OPTH

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“…Successful treatment of optic disc drusen with CNVM has been reported with surgery, 123; 200 laser photocoagulation, 38 photodynamic therapy, 29; 193 and more recently intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents. 2; 9; 37; 69; 84; 99; 175 Both bevacizumab and ranibizumab have been used successfully in children with CNVM secondary to optic disc drusen as young as five years of age.…”

Section: Treatmentmentioning

confidence: 99%

Optic disk drusen in children

Chang

Pineles

2016

Survey of Ophthalmology

113

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Optic disc drusen occur in 0.4% of children and consist of acellular intracellular and extracellular deposits that often become calcified over time. They are typically buried early in life and generally become superficial, and therefore visible, later in childhood, at the average age of 12 years. Their main clinical significance lies in the ability of optic disc drusen, particularly when buried, to simulate true optic disc edema. Misdiagnosing drusen as true disc edema may lead to an invasive and unnecessary workup for elevated intracranial pressure. Ancillary testing, including ultrasonography, fluorescein angiography, fundus autofluorescence, and optical coherence tomography, may aid in the correct diagnosis of optic disc drusen. Complications of optic disc drusen in children include visual field defects, hemorrhages, choroidal neovascular membrane, non-arteritic anterior ischemic optic neuropathy, and retinal vascular occlusions. Treatment options for these complications include ocular hypotensive agents for visual field defects and intravitreal anti-vascular endothelial growth factor (anti-VEGF) agents for choroidal neovascular membranes. In most cases, however, children with optic disc drusen can be managed by observation with serial examinations and visual field testing, once true optic disc edema has been excluded.

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“…71 PDT with verteporfin can be considered in the pediatric population; several case reports suggest that pediatric patients require fewer re-treatments compared with adult patients to stabilize CNV and achieve an improvement in visual acuity; however, atrophic changes in RPE can occur. 36,65,74,75 In our study, both eyes undergoing surgical removal of CNV (100%) showed improved visual outcome without recurrence. In eyes undergoing surgical removal of subfoveal CNV, Sears et al 17 reported visual improvement in 83.3% eyes and a recurrence rate of 33%; Uemura and Thomas 16 reported visual improvement in 72% and a recurrence rate of 35%.…”

Section: Historic Treatmentsmentioning

confidence: 74%

Choroidal neovascularization in 36 eyes of children and adolescents

Rishi

Gupta

Rishi

et al. 2013

Eye

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Purpose To describe the clinical features and outcomes among eyes with choroidal neovascularization (CNV) in children and adolescents. Methods A total of 36 eyes of 27 patients o18 years of age diagnosed with CNV between January 1978 and December 2008 were retrospectively reviewed. CNV was clinically diagnosed in all patients and its presence was confirmed by fundus fluorescein angiography (FFA). A total of 19 eyes underwent treatment. Anatomical outcome was evaluated as regressed/ persistent/recurrent CNV. Snellen's values for best corrected visual acuity (BCVA) were converted to logMAR for statistical calculations. Results Of the 27 patients, 17 (63%) were male. Nine (33.3%) of the 27 patients had bilateral CNV. At presentation, CNV was active in 22 (61.1%) eyes and regressed in 14 (28.9%) eyes. All active CNV cases were 'classic' type, with the majority (80.5%) being subfoveal. The mean greatest linear dimension (GLD) was 3.16 ± 1.94 mm (range, 0.9-10.15). The most common cause (41.7%) was post-inflammatory. The mean duration to regression in treated eyes was 103.53 days (15 eyes). Recurrence was noted in three (8.3%) eyes. The mean duration to first recurrence was 260 days (range, 90-390), and the mean follow-up duration was 779.53 ± 988.00 days. Conclusion CNV remains a cause of significant visual decline in children and adolescents. Male predominance, postinflammatory etiology, bilateral affection, and subfoveal location are noteworthy, with a high regression rate in response to treatment. Re-treatment is required in a limited number of cases.

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Bilateral Cnv Associated with Optic Nerve Drusen Treated with Photodynamic Therapy with Verteporfin

Abstract: Subfoveal CNV is an uncommon complication of OND and excellent anatomic and functional results can be obtained with PDT.

Cited by 23 publications

References 4 publications

Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy

Bilateral choroidal neovascularization associated with optic nerve head drusen treated by antivascular endothelial growth factor therapy

Optic disk drusen in children

Choroidal neovascularization in 36 eyes of children and adolescents

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