Three-year visual and anatomic results of administrating intravitreal bevacizumab in inflammatory ocular neovascularization

Mansour, Ahmad M.; Arévalo, J. Fernando; Fardeau, Christine; Hrisomalos, Emily N.; Chan, Wai Man; Lai, Timothy Y. Y.; Ziemssen, Focke; Neß, Thomas; Sibai, Abla Mehio; Mackensen, Friederike; Wolf, Armin; Hrisomalos, Nicholas F.; Heiligenhaus, Arnd; Spital, Georg; Jo, Yukari; Gomi, Fumi; Ikuno, Yasushi; Akesbi, Jad; LeHoang, Phuc; Adán, Alfredo; Mahendradas, Padmamalini; Khairallah, Moncef; Guthoff, Rainer; Ghandour, Blanche; Küçükerdönmez, Cem; Kurup, Shree K.

doi:10.1016/j.jcjo.2012.03.042

Cited by 42 publications

(23 citation statements)

References 34 publications

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“…Several reports have shown promising results of anti-VEGF therapy for retinal NV in the setting of uveitis. 30–32 In one study, bevacizumab was supplemented with panretinal photocoagulation, but when and how often this treatment was applied was not described. 32 Future studies could incorporate ultra-wide field fluorescein angiography, which can assess a broader area of retina for disease activity and ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…30–32 In one study, bevacizumab was supplemented with panretinal photocoagulation, but when and how often this treatment was applied was not described. 32 Future studies could incorporate ultra-wide field fluorescein angiography, which can assess a broader area of retina for disease activity and ischemia. 29 Additional studies will be necessary to determine the best combination of treatments for patients with uveitis and retinal neovascularization.…”

Section: Discussionmentioning

confidence: 99%

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Risk of Retinal Neovascularization in Cases of Uveitis

et al. 2016

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Objective To evaluate the risk of and risk factors for retinal neovascularization (NV) in cases of uveitis. Design Retrospective cohort study. Participants Patients with uveitis at four US academic ocular inflammation subspecialty practices. Methods Data were ascertained by standardized chart review. Prevalence data analysis used logistic regression. Incidence data analysis used survival analysis with time-updated covariates where appropriate. Main Outcome Measures Prevalence and incidence of NV. Results Among uveitic eyes of 8931 patients presenting for initial evaluation, 106/13,810 eyes had NV (prevalence=0.77%, 95% confidence interval (CI): 0.60%–0.90%). Eighty-eight more eyes developed NV over 26,465 eye-years (incidence=0.33%/eye-year, 95% CI: 0.27–0.41%). Factors associated with incident NV include age <35 as compared to >35 years (adjusted hazard ratio (aHR) = 2.4, 95% CI: 1.5–3.9), current cigarette smoking (aHR=1.9, 95% CI: 1.1–3.4), and systemic lupus erythematosus (aHR=3.5, 95% CI: 1.1–11). Recent diagnosis of uveitis was associated with an increased incidence of NV (compared to patients diagnosed >5 years ago, aHR=2.4 (95% CI 1.1–5.0) and aHR=2.6 (95%CI 1.2–6.0) for diagnosis within <1 year vs. 1–5 years respectively). Compared to anterior uveitis, intermediate uveitis (aHR=3.1, 95% CI: 1.5–6.6), posterior uveitis (aHR=5.2, 95% CI: 2.5–11), and panuveitis (aHR=4.3, 95% CI: 2.0–9.3) were associated with a similar degree of increased NV incidence. Active (aHR=2.1, 95%CI: 1.2–3.7) and slightly active (aHR=2.4, 95%CI: 1.3–4.4) inflammation were associated with an increased incidence of NV as compared to inactive inflammation. NV incidence also was increased with retinal vascular occlusions (aHR=10, 95% CI: 3.0–33), retinal vascular sheathing (aHR=2.6, 95% CI: 1.4–4.9), and exudative retinal detachment (aHR=4.1, 95% CI: 1.3–13). Diabetes mellitus was associated with a somewhat increased incidence of retinal NV (aHR=2.3, 95% CI: 1.1–4.9); and systemic hypertension (aHR 1.5; 95% CI:0.89–2.4) was associated with non-significantly increased NV incidence. Results were similar in sensitivity analyses excluding the small minority of patients with diabetes mellitus. Conclusions Retinal neovascularization is a rare complication of uveitis, which occurs more frequently in younger patients; smokers; and those with intermediate/posterior/panuveitis, systemic vasculopathy and/or retinal vascular disease; and active inflammation. Inflammation and retinal neovascularization likely are linked; additional studies are needed to further elucidate this connection.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk of Retinal Neovascularization in Cases of Uveitis

et al. 2016

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“…88 In case of ME related to inflammatory CNV, the longterm efficacy of intravitreal bevacizumab has been reported by Mansour et al in a study of 81 patients with uveitis. 89 They have observed a significant increase in VA in patients with histoplasmosis, multifocal choroiditis, punctate inner chorioretinopthy and toxoplasmosis, as well as a significant decrease in foveal thickness in the overall patient group. At 3 years, significant sustained visual improvement of 2.7 lines and foveal flattening of 98 μm have been observed in numerous inflammatory ocular diseases without major complications after a median of 3 intravitreal bevacizumab injections.…”

Section: Benefits Of Intravitreal Injectionsmentioning

confidence: 94%

“…At 3 years, significant sustained visual improvement of 2.7 lines and foveal flattening of 98 μm have been observed in numerous inflammatory ocular diseases without major complications after a median of 3 intravitreal bevacizumab injections. 89 Prospective studies are ongoing to assess the efficacy of intravitreal ranibizumab and aflibercept on inflammatory CNV.…”

Section: Benefits Of Intravitreal Injectionsmentioning

confidence: 99%

Uveitic macular edema

Fardeau

Champion

Massamba

et al. 2016

Eye

117

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“…In contrast to PIC lesions, APMPPE lesions are typically placoid and often confl uent. ICGA fi ndings are useful in excluding the infectious causes [ 164 ].…”

Section: Differential Diagnosismentioning

confidence: 99%