Purpose To report the visual and anatomical outcomes in eyes with peripapillary choroidal neovascularisation (CNV) through 12 months.
Methods This was a multicentre, retrospective, interventional case series which included treatment-naïve cases of peripapillary choroidal neovascular membrane (CNVM) with a minimum follow-up of 12 months. Multimodal imaging which comprised optical coherence tomography (OCT), fluorescein angiography and/or indocyanine green angiography was performed at baseline and follow-up visits. OCT parameters included central macular thickness (CMT), subfoveal choroidal thickness (SFCT) and retinal and choroidal thickness at site of CNV. Patients were treated with anti-vascular endothelial growth factors (VEGF) on pro re nata protocol, photodynamic therapy, laser photocoagulation or a combination. Main outcome measures were change in best corrected visual acuity (BCVA) and OCT parameters.
Results A total of 77 eyes (74 patients; mean age: 61.9±21.8 years) with a mean disease duration of 9.2±14.1 months were included. BCVA improved significantly from 0.55±0.54 logMAR (20/70) at baseline to 0.29±0.39 logMAR (20/40) at 12 months (p<0.001) with a mean of 4.9±2.9 anti-VEGF injections. CMT, SFCT and retinal thickness at site of CNVM reduced significantly (p<0.001, <0.001 and 0.02, respectively) through 12 months. The most common disease aetiologies were neovascular age-related macular degeneration, and idiopathic, inflammatory and angioid streaks. Age (p=0.04) and baseline BCVA (p<0.001) were significant predictors of change in BCVA at 12 months.
Conclusion Peripapillary CNVM, though uncommon, is associated with diverse aetiologies. Anti-VEGF agents lead to significant visual acuity and anatomical improvement in these eyes over long term irrespective of the aetiology.
- peripapillary choroidal neovascularisation (CNV)
- age-related macular degeneration (AMD)
- inflammatory cnv
- angioid streaks
- optic nerve head drusen
- idiopathic intracranial hypertension (IIH)
- anti-vascular endothelial growth factors (VEGF)
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Contributors ATF, ML, AMM, CF, JFA and JC were involved in the design of the study. ATF, SFB, ML, SM, DZ, MI, RGP, AMM and JC were involved in the collection of data. SRS, ATF, ML, MI, AMM and LW were responsible for interpretation and analysis of data. SRS, ATF, SFB, ML, PHG, DZ, PMLC, LHL, RS, SHU and JC were involved in manuscript writing. SRS, ATF, SFB, ML, SM, PHG, DZ, MI, PML, RGP, CF, LHL, AMM, AMBC, LW, RS, SHU, VG, JFA and JC reviewed the article. All authors conducted the study and equally contributed in the preparation, review and approval of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study was approved by the local ethics committee and the institutional review board at the respective sites.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon request.