Combination Treatment With Intravitreal Injection of Ranibizumab and Reduced Fluence Photodynamic Therapy for Choroidal Neovascularization Secondary to Angioid Streaks

Artunay, Özgür; Yüzbaşıoğlu, Erdal; Rasier, Rıfat; Şengül, Elvan Alper; Şenel, Amber; Bahçecioğlu, Halil

doi:10.1097/iae.0b013e318205b228

Cited by 14 publications

(11 citation statements)

References 34 publications

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“…Treatment options have included laser photocoagulation, photodynamic therapy, and intravitreal anti-vascular endothelial growth factor drugs 5,9,11,13. The latter are the only ones that have proven to be able to induce visual stabilization or increase visual acuity up to 3 years after onset of the treatment 11,14.…”

Section: Introductionmentioning

confidence: 99%

Long-term follow-up of patients with choroidal neovascularization due to angioid streaks

Martínez-Serrano

Rodríguez-Reyes²,

Guerrero-Naranjo³

et al. 2016

OPTH

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BackgroundThe following case series describes the long-term anatomical and functional outcome of a group of seven patients with choroidal neovascularization (CNV), secondary to angioid streaks (AS), who were treated with antiangiogenic drugs in a pro re nata (PRN) regimen. After the 4-year mark, visual acuity tends to return to pretreatment level. Treatment delays and lack of awareness and self-referral by the patients are believed to be the cause of the PRN regimen failure.PurposeTo assess the long-term outcomes (>4 years) of patients with CNV due to AS treated with a PRN regimen of antiangiogenic.MethodsThis was a retrospective, case series, single-center study. We reviewed the electronic medical records from patients with CNV due to AS. From each record, we noted general demographic data and relevant medical history; clinical presentation, changes in best-corrected visual acuity (BCVA) over time, optical coherent tomography parameters, treatment and retreatment details, and systemic associations. Changes in BCVA and central macular thickness were assessed with a Wilcoxon two-sample test, with an alpha value of ≤0.05 for statistical significance.ResultsThe mean follow-up time was 53.8±26.8 months. BCVA at baseline was: 1.001±0.62 logMAR; at the end of follow-up: 0.996±0.56 logMAR (P=0.9). Central macular thickness at baseline was: 360.85±173.82 μm; at the end of follow-up: 323.85±100.34 μm (P=0.6). Mean number of intravitreal angiogenic drugs: 6±4.16 injections (range 4–15). Mean time between injections was 3.8±2.7 months (range 1.9–5.8 months).ConclusionDespite initial anatomical and functional improvement, patients at the end of the follow-up had no visual improvement after a pro re nata regimen of antiangiogenic drugs. The amount of retreatments, number of recurrences, and time between intravitreal injections were similar to previous reports with shorter follow-up.

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Section: Introductionmentioning

confidence: 99%

Long-term follow-up of patients with choroidal neovascularization due to angioid streaks

Martínez-Serrano

Rodríguez-Reyes²,

Guerrero-Naranjo³

et al. 2016

OPTH

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“…Encouraging anatomical results were achieved in all studies except one [24] , and these studies report a reduction or at least a stabilization of the central retinal thickness measured by optical coherence tomography (OCT) [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] . It was also shown that combination therapies do not yield better results than monotherapy [28,[42][43][44] . At present, in chronically active AS-related CNV, the available treatments do not prevent the functional loss but rather limit it [23,45] .…”

Section: Introductionmentioning

confidence: 99%

Long-Term Follow-Up of Choroidal Neovascularization due to Angioid Streaks with pro re nata Intravitreal Anti-VEGF Treatment

et al. 2017

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Purpose: To evaluate the long-term outcomes of intravitreal anti-vascular endothelial growth factor (VEGF) drugs with a pro re nata (PRN) regimen for the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS). Methods: This is a retrospective, multicenter, noncomparative case series of consecutive AS eyes affected by treatment-naïve CNV. A complete ophthalmologic examination was performed every 30-45 days after the loading phase, including fluorescein angiography and/or optical coherence tomography. Results: In all, 52 eyes of 39 patients were treated with intravitreal bevacizumab and/or ranibizumab and followed up for a mean of 33.8 months. The best corrected visual acuity at baseline was 20/40, and it deteriorated by an average of 6.8 ETDRS letters per year (p < 0.001). We performed an average of 5.1, 6.5, and 6.8 injections at the 1-, 2-, and 3-year follow-up, respectively. Conclusions: Intravitreal anti-VEGF drugs in a PRN regimen with close monitoring appear to slow the progression of CNV in AS, but they do not prevent the affected eyes from progressive visual loss.

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“…This observation has been confirmed in long-term studies with follow-up times exceeding one year, that report recurrent or newly developed CNV in different regions in half of the study cohorts 17,18,27. The use of intravitreal ranibizumab (Lucentis ® , Genetech Inc), the antigen-binding fragment of recombinant, humanized monoclonal antibody that neutralizes all active forms of VEGF A, was also used in CNV-related angioid streaks with promising results 32. The largest published retrospective case series investigating the use of ranibizumab in CNV secondary to angioid streaks demonstrated a stabilization of visual acuity over 24 months with a mean of 5.7 injections 27…”

Section: Discussionmentioning

confidence: 78%

Long-term follow-up of choroidal neovascularization secondary to angioid streaks: case series and literature review

Al-Rashaed¹,

Arévalo²

2012

OPTH

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BackgroundThe purpose of this paper is to report the clinical course of choroidal neovascularization (CNV) secondary to angioid streaks and the outcomes in response to different treatment modalities.MethodsThis was a case series of two consecutive patients (four eyes) with CNV secondary to angioid streaks. Visual acuity, ophthalmological examination, color photographs, fluorescein angiography, and optical coherence tomography were used to assess the outcomes of treatment.ResultsTwo eyes were treated with photodynamic therapy for subfoveal choroidal neovascular membrane, one eye underwent thermal laser photocoagulation for extrafoveal CNV followed by intravitreal bevacizumab for subfoveal CNV, and one eye underwent intravitreal bevacizumab for subfoveal CNV. The follow-up period was 4–6 years. The final visual acuities of all eyes were 20/300 or worse with large submacular fibrosis.ConclusionCNV secondary to angioid streaks in these two patients had a poor prognosis despite undergoing different types of treatment. Poor outcome was likely related to frequent recurrence and newly developed CNV, which remained a clinical concern in these cases.

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Combination Treatment With Intravitreal Injection of Ranibizumab and Reduced Fluence Photodynamic Therapy for Choroidal Neovascularization Secondary to Angioid Streaks

Cited by 14 publications

References 34 publications

Long-term follow-up of patients with choroidal neovascularization due to angioid streaks

Long-term follow-up of patients with choroidal neovascularization due to angioid streaks

Long-Term Follow-Up of Choroidal Neovascularization due to Angioid Streaks with pro re nata Intravitreal Anti-VEGF Treatment

Long-term follow-up of choroidal neovascularization secondary to angioid streaks: case series and literature review

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