Incidence and Risk Factors of Visual Impairment in Patients with Angioid Streaks and Macular Neovascularization

Cicinelli, Maria Vittoria; Torrioli, Edoardo; Franca, Lamberto La; Agrawal, Hitesh; Barthelmes, Daniel; Chhablani, Jay; Chowers, Itay; Foa, Nastasia; Goldstein, Michaella; Mansour, Ahmad M.; Muhammed, Raheeba Pakeer; Sivaprasad, Sobha; Vilela, Manuel Augusto Pereira; Zweifel, Sandrine; Bandello, Francesco; Parodi, Maurizio Battaglia

doi:10.1016/j.oret.2022.12.002

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…The development of new CNV is the single most important cause of acute visual loss in patients with AS. 12,17 Its common occurrence in young adults of working age (50 years of age or less) is even more relevant because its high incidence of recurrence, potential for scarring and permanent visual disability may damage a patient's employment prospects, cause signi cant loss of personal revenue, disrupt the patient's family dynamics, and worsen his or her quality of life. 12,13,[18][19][20] The current study describes the long-term visual outcome, response to anti-VEGF treatment, and rate of disease recurrence over time in a group of patients with AS-CNV.…”

Section: Discussionmentioning

confidence: 99%

“…12,17 Its common occurrence in young adults of working age (50 years of age or less) is even more relevant because its high incidence of recurrence, potential for scarring and permanent visual disability may damage a patient's employment prospects, cause signi cant loss of personal revenue, disrupt the patient's family dynamics, and worsen his or her quality of life. 12,13,[18][19][20] The current study describes the long-term visual outcome, response to anti-VEGF treatment, and rate of disease recurrence over time in a group of patients with AS-CNV. Moreover, the risk of recurrence was calculated according to qualitative analysis of CNV lesions by OCT and OCTA, and the ndings were compared against those of a group of patients who were long believed to exhibit a similar evolution and response to treatment (mCNV).…”

Section: Discussionmentioning

confidence: 99%

“…1,6,9,10 Nevertheless, real-life studies have shown that, in contrast to myopic CNV, AS-CNV is characterized by a high level of recurrence and longer exudative periods, leading to the progressive loss of initial gains even to the point of returning to baseline and, in time, to be more prone to subretinal scarring. 1,5,[11][12][13] It is believed that the main reason for the latter complication could be that anti-VEGF treatment in AS patients is usually reactive rather than proactive. 13 This means that patients are more often allocated to a pro-re-nata (PRN) treatment regimen that might leave them exposed to future episodes of exudation, which we cannot predict accurately.…”

Section: Introductionmentioning

confidence: 99%

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Qualitative analysis by OCTA in patients with choroidal neovascularization secondary to angioid streaks as predictors of disease recurrences over time

Velez-Montoya,

Osorio-Landa,

Franco-Ramirez

et al. 2024

Preprint

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Background: To report the risk of exudation recurrence and long-term outcomes in patients with choroidal neovascularization secondary to angioid streaks, according to its morphology and characteristics by optical coherence tomography angiography. Methods: Retrospective analysis of electronic medical records from three hospitals. We enrolled patients with a clinical diagnosis of angioid streaks choroidal neovascularization that had a minimum follow-up of 12 months. From each record, we extracted general demographic data, best corrected visual acuity (baseline, before and after each disease recurrence and last on file), type of treatment, time between last intravitreal injection and disease recurrence, and classification of the neovascular lesion morphology by optical coherence tomography, and optical coherence tomography angiography. Patients with myopic choroidal neovascularization were used as controls. Interobserver agreement was assessed with a Cohen-Kappa test. The Odds ratio was calculated with a chi2 test for significance. Visual acuity change through time was assessed with an ANOVA for repeated measurements with an alpha value of 0.05 for statistical significance. Results: We enrolled 30 patients in the study group and 14 in the control group. In the study group, the baseline and final BCVA was 0.861 ± 0.59 and 1.095 ± 0.61 logMAR (p=0.1). Control group: 1.045 ± 0.57 and 0.617 ± 0.53 logMAR (p<0.05). In the study group, the predominant CNV type by OCTA was mixed (37%), and interlacing (57%) in the control group. Mixed and cog-wheel patterns at baseline had increased Odds for recurrence in the study group (1.2 to 7.4) although it was not significant. Patients in the study group required fewer intravitreal injections on each recurrence episode to achieve disease control (3.5±1.5 vs.1.4±0.2, p<0.01). Conclusions: The benefits of anti-VEGF treatment are lost over time in patients with angioid streaks and CNV. Lesion characteristics by optical coherence tomography angiography could help physicians predict the risk of recurrence. Trial Registration:Retrospective registered, and IRB approved.

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