Inflammatory choroidal neovascularization: An evidence-based update

Area of Science:

• Ophthalmology
• Immunology
• Vascular Biology

Background:

• Inflammatory choroidal neovascularization (iCNV) is a major cause of vision impairment, often stemming from infectious or noninfectious uveitis.
• Its development involves Bruch membrane damage, inflammation, and reduced blood flow to the choroid.
• Diagnosing iCNV is difficult due to overlapping symptoms with other uveitis conditions.

Purpose of the Study:

• To provide an updated overview of iCNV, consolidating recent research on its epidemiology, pathogenesis, and risk factors.
• To highlight the role of advanced imaging techniques in iCNV detection and differentiation.
• To review current and emerging treatment strategies for iCNV.

Main Methods:

• Comprehensive review of recent scientific literature on iCNV.
• Emphasis on multimodal imaging, including optical coherence tomography (OCT) and OCT angiography (OCTA).
• Analysis of treatment efficacy, particularly anti-VEGF agents and anti-inflammatory therapies.

Main Results:

• iCNV diagnosis is challenging, necessitating advanced imaging like OCT and OCTA for accurate detection.
• Anti-VEGF therapies are effective, but their combination with anti-inflammatory treatments requires further investigation.
• Limited randomized clinical trials exist due to iCNV's rarity, leading to reliance on case studies.

Conclusions:

• Early and accurate diagnosis of iCNV is crucial and achievable with advanced imaging techniques.
• Integrated treatment approaches combining anti-VEGF and anti-inflammatory strategies are promising but need more research.
• Further research and standardized guidelines are essential for effective iCNV management.