Intravitreal Ranibizumab for Choroidal Neovascularization in Angioid Streaks

Abstract

In this large series of patients with choroidal neovascularization associated with angioid streaks followed for 4 years, ranibizumab injections allowed stabilization of best-corrected visual acuity in most eyes. Ranibizumab appear as an effective therapeutic option in CNV associated with angioid streaks over long time.

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

“…This may lead to severe and fast visual deterioration in middle-aged working patients, due to exudation, hemorrhage, and subsequent subretinal fibrosis and atrophy 7,11. If left untreated, visual prognosis is poor, often leading to legal blindness and huge economic repercussions due to visual disabilities on a relatively young population 5,6,12…”

Intravitreal aflibercept for choroidal neovascularisation in angioid streaks

“…While we find the T&E modality to be an interesting approach for AS-associated CNV, we agree with previous reports that the CNV in this context is closer to myopia-related CNV than nAMD-related CNV, and therefore may require fewer injections. 4 Additionally, patients can be activity-free for several years, or develop new CNV lesions in a different location altogether, making it difficult to identify a specific pattern of recurrence. 4 This could lead to overtreatment with subsequent increase of associated risks such as chorioretinal atrophy.…”

“…4 Additionally, patients can be activity-free for several years, or develop new CNV lesions in a different location altogether, making it difficult to identify a specific pattern of recurrence. 4 This could lead to overtreatment with subsequent increase of associated risks such as chorioretinal atrophy. 5 Even though larger prospective trials are needed to elucidate on the best treatment protocol, they are difficult to arrange due to the rarity of the condition.…”

“…2 This approach, in which treatment is withheld unless there is CNV activity, has been the most widely adopted in this setting. 3,4 Treat and extend (T&E) is a treatment modality that aims to treat the CNV proactively, in order to find an optimal treatment interval, and has been more commonly used in the context of neovascular age-related macular degeneration (nAMD). While we find the T&E modality to be an interesting approach for AS-associated CNV, we agree with previous reports that the CNV in this context is closer to myopia-related CNV than nAMD-related CNV, and therefore may require fewer injections.…”

Treat and extend regimen with aflibercept for choroidal neovascularization in angioid streaks

“…4 All babies born less than 32 weeks gestational age (GA) (up to 31 weeks and 6 days) or less than 1501 g birth weight should be screened for ROP. Infants born before 27 weeks GA (ie up to 26 weeks and 6 days) should have their initial ROP screening examination at 30 − 31 weeks postmenstrual age (PMA).…”