Improved Visual Outcome and Low Recurrence with Early Treatment with Intravitreal Anti-Vascular Endothelial Growth Factor in Myopic Choroidal Neovascularization

Moon, Byung Gil; Cho, Ah Ran; Lee, Junyeop; Kim, Yoon Jeon; Lee, Joo Yong; Kim, June-Gone; Yoon, Young Hee

doi:10.1159/000458160

Cited by 9 publications

(4 citation statements)

References 25 publications

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“…In the present study, we found that the recurrence rate was 20.2%, which was consistent with previous findings. Under no difference in treatment, the present study suggested that the duration of illness on initial diagnosis in the recurrence group was longer than that in the non-recurrence group, which was an independent risk factor for IgAV recurrence (P = 0.000), and consistent with findings of many other studies [23][24][25][26]. The reason for this finding may be that in autoimmune diseases, early treatment can promote the transformation from immune response involved by non-specific T cells and antibodies to that involved by specific T cells and antibodies as soon as possible, avoiding further tissue injury resulting from excessive activation of immune cells and release of more inflammatory factors [27].…”

Section: Discussionsupporting

confidence: 91%

Association between common laboratory indices and IgAV recurrence in children

Zhou

Luo

et al. 2022

BMC Pediatr

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Background IgA vasculitis (IgAV) is a common type of vasculitis seen in children. IgAV recurrence can result in chronic kidney disease. We aimed to explore the association between common laboratory indices and IgAV recurrence in children, and to establish a prediction model. Methods This retrospective study included children with diagnosed with IgAV hospitalized in Bazhong Central Hospital, Sichuan, from January 2014 to December 2019. Children were assigned to two groups based on IgAV recurrence, and baseline clinical data were collected for comparison. A logistic regression model to predict IgAV recurrence was established. The receiver operating characteristic curve was plotted. The area under the curve (AUC) was used to detect performance of the predictive model. Results This study included 193 children (39 [20.2%], recurrence group; 154 [79.8%], non-recurrence group). Based on multivariate regression analysis, the duration of illness and joint involvement were independent predictors of IgAV recurrence in children (P < 0.05). No significant differences were observed in common laboratory indices (P > 0.05). The AUC of the prediction model was 0.766 (P < 0.001) with sensitivity of 74.4% and specificity of 68.8%. Conclusion Common laboratory indices were not associated with recurrence of IgAV in children.

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Section: Discussionsupporting

confidence: 91%

Association between common laboratory indices and IgAV recurrence in children

Zhou

Luo

et al. 2022

BMC Pediatr

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“…Wakazono et al [25] reported that exudative AMD recurred in 43.7% of patients after aflibercept treatment. Moon et al [26] reported that 34.9% of patients with myopic CNV experienced recurrence, and two other studies reported that 23.3% and 22.7%, respectively, showed recurrence of CNV [27,28]. In the present study, the rate of recurrence of PCV was 59.7%, which is significantly higher than that of myopic CNV.…”

Section: Discussionsupporting

confidence: 43%

Characteristics of Recurrence in Patients with Polypoidal Choroidal Vasculopathy and Myopic Choroidal Neovascularization

Lim

Park

et al. 2019

J Retin

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Purpose: To investigate the characteristics of recurrence in patients with polypoidal choroidal vasculopathy (PCV) and myopic choroidal neovascularization (CNV). Methods: In total, 72 eyes from 70 patients with PCV and 51 eyes from 49 patients with myopic CNV were included. PCV and myopic CNV patients were followed up with a pro-re-nata regimen after three monthly injections of anti-vascular endothelial growth factor and underwent spectral-domain optical coherence tomography (SD-OCT). Changes in visual acuity and SD-OCT findings of macular lesions after recurrence were analyzed. Results: We observed a significant difference in recurrence of PCV (59.7%) and myopic CNV (35.3%) during the follow-up period (p = 0.008). With the first recurrence, we observed higher levels of subretinal fluid (SRF) in patients with PCV (93.0%) than myopic CNV (22.2%; p < 0.001). In addition, we observed more subretinal hyperreflective lesions with blurred margins on SD-OCT for patients with myopic CNV (88.9%) than with PCV (18.6%; p < 0.001). Changes in central macular thickness (CMT) following recurrence were greater for patients in the PCV group than in the myopic CNV group (p = 0.024). However, visual acuity was lower in patients with myopic CNV than with PCV (p = 0.001). Conclusions: We observed a greater number of new SRF than subretinal hemorrhage in patients with recurrent PCV, whereas a subretinal hyperreflective lesion with a blurred margin was a major finding in patients with myopic CNV. Myopic CNV patients experienced a greater decrease in visual acuity at recurrence than PCV patients despite minimal changes in CMT.

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“…is percentage seems to be lower than in myopic CNV or neovascular AMD [17][18][19][20]. In fact, since CNV was secondary to an inflammatory aetiology, managing the primary disease with an anti-inflammatory/immunosuppressive approach allows better disease control, reducing recurrence and need for anti-VEGF injections.…”

Section: Discussionmentioning

confidence: 99%

Inflammatory Choroidal Neovascular Membranes: Clinical Profile, Treatment Effectiveness, and Visual Prognosis

Carrola

Lima-Fontes

Falcão‐Reis

et al. 2021

Journal of Ophthalmology

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Purpose. To characterise a sample of patients with inflammatory choroidal neovascularization (I-CNV), including clinical profile, underlying aetiology and its course, treatments performed, associated clinical response, and visual prognosis. Methods. Retrospective analysis of patients with a diagnosis of I-CNV followed at the Ophthalmology Department of Centro Hospitalar Universitário de São João (CHUSJ). Clinical and visual outcomes were classified according to the difference in visual acuity after treatment. Results. Twenty eyes from 17 patients were analysed (11 female and 6 male patients, mean age 41.90 ± 16.457 years at CNV diagnosis). Punctate inner choroidopathy/multifocal choroiditis was the predominant inflammatory aetiology (10 patients, 58.82%). Median follow-up time was 46 months (range 10 to 188 months). Neovascularization was treated with intravitreal anti-VEGF injections (bevacizumab, aflibercept, and ranibizumab), and inflammation with anti-inflammatory/immunosuppressive therapy (oral, intravenous, and/or intravitreal corticosteroids; oral cyclosporine or methotrexate). Intravitreal anti-VEGF agents had a median number of 7.00 injections (IQR, 4.25 to 29.00). Visual acuity among 20 eyes had a mean gain of 15.10 ± 12.998 ETDRS letters after anti-VEGF treatment ( p = 0.000051 ). According to our classification, 16 had an improved outcome (80.00%), 3 had a stable outcome (15.00%), and 1 had a worsened visual outcome (5.00%). In addition, 13 eyes (65.00%) had a final VA equal to or greater than 65 letters. Recurrence was seen in 3 eyes (15.00%). Complications included cataract (6 patients) and ocular hypertension (4 patients). Conclusion. A combined approach with anti-VEGF agents and anti-inflammatory therapy was effective in I-CNV treatment, and an overall good visual prognosis was attainable. Intensive follow-up was fundamental in the management of both the primary inflammatory and secondary neovascular conditions.

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Improved Visual Outcome and Low Recurrence with Early Treatment with Intravitreal Anti-Vascular Endothelial Growth Factor in Myopic Choroidal Neovascularization

Cited by 9 publications

References 25 publications

Association between common laboratory indices and IgAV recurrence in children

Association between common laboratory indices and IgAV recurrence in children

Characteristics of Recurrence in Patients with Polypoidal Choroidal Vasculopathy and Myopic Choroidal Neovascularization

Inflammatory Choroidal Neovascular Membranes: Clinical Profile, Treatment Effectiveness, and Visual Prognosis

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