Session Title: AMD III
Session Date/Time: Sunday 29/09/2013 | 11:00-13:00
Paper Time: 11:16
Venue: Hall G1 (Level 2)
First Author: F.Zacharaki UK
Co Author(s): M. Chandran S. Nambiar G. Menon
The aim of this retrospective study is to review the underlining pathology, clinical management and visual outcome of patients with Peripapillary Choroidal Neovascular Membrane (PCNM) who were treated with intravitreal injections of anti- vascular endothelial factor (anti-VEGF) bevacizumab and had a follow-up period of 12 months.
A PCNM is a collection of new choroidal blood vessels, any portion of which lies within one disc diameter of the optic nerve head. Clinical manifestations occur following membrane extension, haemorrhage or fluid exudation within the macula. Treatment modalities include laser, photodynamic therapy, surgery and, recently, anti- VEGF intravitreal injections.
Fifteen eyes of 13 patients were included in this study. At baseline, all patients underwent a complete ophthalmic examination including best-corrected visual acuity (BCVA) using the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart, dilated fundus examination, spectral domain optical coherence tomography (SD-OCT) imaging using Heidelberg HRA-Spectralis system (Heidelberg Engineering, Heidelberg, Germany) and fluorescein fundus angiography (FFA). Patients with macular involvement in the form of subretinal or intraretinal fluid in the macular area were treated with intravitreal bevacizumab (Avastin ®) 1.25mg/0.05ml. After a single initial injection, they were followed-up at 4-week intervals and had repeat injections as needed. The main retreatment criterion was existence of fluid at the macula as shown at the OCT.
All patients were Caucasian, with a mean age of 76 years (SD ±12), 9 females and 4 males. In one patient PCNM was secondary to multifocal choroiditis (6.6%), one patient had history of chronic Central Serous Chorioretinopathy (CSCR), and one had high myopia. Only one patient had other treatment previously (laser). The mean number of bevacizumab injections was 5.8 (range: 1–10). Mean BCVA at baseline was 62.73 (SD±15.517) and at 12 months 71.4 (SD±12). Mean VA change compared with baseline was 8.67 letters. No adverse events were recorded.
Our results indicate that intravitreral anti-VEGF injections might be an effective treatment option for patients with PCNM of any aetiology.