Abstract
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.
Highlights
Inflammatory choroidal neovascularization (I-CNV) is characterised by the pathologic growth of blood vessels from the choroid to the subretinal and/or subretinal pigment epithelium spaces due to an inflammatory cause [1, 2]
17 patients were included. e majority, 14 patients, had only one eye affected with CNV (82.35%), and 3 had both eyes affected (P5, P11, and P12; 17.65%). us, a total of 20 affected eyes were analysed
We described a group of 17 patients with a total of 20 eyes affected with I-CNV and compared their clinical profiles, treatments performed, and visual outcomes
Summary
Inflammatory choroidal neovascularization (I-CNV) is characterised by the pathologic growth of blood vessels from the choroid to the subretinal and/or subretinal pigment epithelium spaces due to an inflammatory cause [1, 2]. Inflammation represents the third most common cause of choroidal neovascularization (CNV), behind age-related macular degeneration (AMD) and pathologic myopia [1]. Regardless of the aetiology, what these entities have in common is a disruption in Bruch’s membrane combined with an inflammatory and angiogenic cascade [3]. Endothelial and inflammatory cell invasion leads to the formation of neovascular membranes with associated leakage and haemorrhage and, a variable degree of vision loss [1, 3]. Inflammatory causes of CNV can be mainly divided into infectious and noninfectious uveitis (Table 1) [1]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
