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AGE-RELATED MACULAR DEGENERATION–ASSOCIATED PERIPAPILLARY CHOROIDAL NEOVASCULARIZATION IN THE ERA OF ANTI–VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY

Lin, Tiezhu, MD*,†; Dans, Kunny, MD*,‡; Meshi, Amit, MD*; Muftuoglu, Ilkay Kilic, MD*,§; Amador-Patarroyo, Manuel J., MD*,¶; Chen, Kevin C., MD*; Cheng, Lingyun, MD*; Freeman, William R., MD*

doi: 10.1097/IAE.0000000000002272
Original Study: PDF Only

Purpose: To characterize the natural history and response of age-related macular degeneration–associated peripapillary choroidal neovascularization to anti–vascular endothelial growth factor therapy.

Methods: This was a retrospective case series of patients with peripapillary choroidal neovascularization secondary to neovascular age-related macular degeneration. All patients underwent complete ophthalmologic examination and retinal imaging including fluorescein angiography and spectral domain optical coherence tomography at each visit. Eyes with subretinal or intraretinal macular fluid were treated with anti–vascular endothelial growth factor monotherapy using a modified as-needed treatment algorithm.

Results: Thirty-three eyes of 27 patients were included. The median age was 82 years (range, 62–94), and the median duration of follow-up was 65 months (range, 6–165). Fourteen eyes (58%) without fovea-involving fluid at baseline subsequently developed exudation after a median observation period of 16 months (range, 4–107). Ten of 24 eyes (42%) without initial macular fluid remained dry during the entire follow-up. The median number of injections required until complete fluid reabsorption was 3 (range, 1–21) during the first treatment cycle. The median time to fluid recurrence was 6 months (range, 3–74).

Conclusion: Peripapillary choroidal neovascularization secondary to wet age-related macular degeneration has a slow progression, may not require treatment for a prolonged period, and responds rapidly to anti–vascular endothelial growth factor treatment with good visual outcomes.

Peripapillary choroidal neovascularization secondary to age-related macular degeneration may not require treatment in some cases, and the visual acuity may remain stable during the course of the disease.

*Department of Ophthalmology, Jacobs Retina Center at the Shiley Eye Institute, University of California San Diego, La Jolla, California;

Department of Ophthalmology, He Eye Hospital, He University, Shenyang, China;

Department of Ophthalmology, DOH Eye Center—East Avenue Medical Center, Quezon City, Philippines;

§Department of Ophthalmology, Istanbul Training and Research Hospital, Istanbul, Turkey; and

Department of Ophthalmology, Ophthalmology Superior School, Barraquer Institute of America, Bogota, Colombia.

Reprint requests: William R. Freeman, MD, Department of Ophthalmology, Jacobs Retina Center, Shiley Eye Institute, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA 92037; e-mail: wrfreeman@ucsd.edu

Supported in part by an UCSD Vision Research Center Core Grant P30EY022589, an unrestricted fund from Research to Prevent Blindness, NY (W.R.F.). The funding organization had no role in the design or conduct of this research. The institution has received funding to conduct trials of anti-VEGF drugs, and the conflicts are managed through UCSD policy.

None of the authors has any financial/conflicting interests to disclose.

© 2018 by Ophthalmic Communications Society, Inc.