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Published on: December 27, 2015
Outcome of Inflammatory Choroidal Neovascularization in Egypt
Samir Shoughy1,2, Hind Amin3, Terese Kamal Gerges4
1Department of Ophthalmology, Doctor Samir Eye Clinic, Alexandria, Egypt.
Insights
Inflammatory choroidal neovascularization (i-CNV) is a sight-threatening complication of uveitis. Treatment led to significant visual acuity and retinal thickness improvements in patients.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Uveitis
Background:
- Inflammatory choroidal neovascularization (i-CNV) is a severe complication of uveitis, potentially leading to vision loss.
- Understanding the clinical features, causes, and treatment outcomes of i-CNV is crucial for effective management.
- Previous studies have highlighted i-CNV as a complication, but comprehensive data on its varied presentations and treatment responses are still evolving.
Purpose of the Study:
- To evaluate the clinical characteristics, underlying causes (etiology), and treatment outcomes of inflammatory choroidal neovascularization (i-CNV).
- To analyze the impact of treatments on visual acuity and retinal structure in patients with i-CNV.
- To identify the prevalence of different i-CNV types and their association with uveitis subtypes.
Main Methods:
- A retrospective, observational, consecutive, multicenter study design was employed.
- Data from 57 patients (71 eyes) with i-CNV were analyzed.
- Treatments were determined by individual physicians, and data collection was not prospective.
Main Results:
- The most frequent underlying conditions were Vogt-Koyanagi-Harada (VKH) disease (47.4%) and idiopathic cases (14%).
- Panuveitis was the most common anatomical type (66.7%). Type 2 i-CNV was most prevalent (67.6%).
- Statistically significant improvements were observed in Best Corrected Visual Acuity (BCVA) and Central Subfield Thickness (CST) following treatment (p=0.002 and p=0.013, respectively).
Conclusions:
- Inflammatory CNV is a significant sight-threatening condition associated with various forms of uveitis.
- The study observed an increased incidence of i-CNV in anterior and intermediate uveitis compared to prior reports.
- The findings indicate that treatment can lead to significant visual and structural improvements in i-CNV patients, even with heterogeneous treatment approaches.
Purpose:
The main aim of this study was to evaluate the clinical features, etiology, and outcome of treatment of inflammatory choroidal neovascularization (i-CNV).
Methods:
A retrospective observational consecutive multicenter study. Treatments were physician dependent. There were no prospective data collection elements.
Results:
A total of 57 patients (71 eyes) were included. The most common underlying diseases included VKH disease, accounting for 47.4% of cases, followed by idiopathic cases (14%), then PIC (10.5%). The most common anatomical type was panuveitis, accounting for (66.7%) of cases, followed by posterior uveitis (19.3%), then intermediate uveitis (10.5%), and the least common was anterior uveitis (3.5%). The most common type of i-CNV in our 71 eyes was type 2, accounting for (67.6%) of cases, followed by Type 1 (19.7%), then Type 3 (11.3%). There was a statistically significant improvement of Best Corrected Visual Acuity (BCVA) after treatment, with a mean BCVA increasing from 0.34 to 0.41 (p = 0.002). Optical Coherence Tomography (OCT) showed a statistically significant change in Central Subfield Thickness (CST) after treatment (p = 0.013), with a notable decrease in cases having CST between 200-300 (from 28.2% to 50.7%). The follow-up duration and treatment modalities were heterogeneous.
Conclusion:
Inflammatory CNV is a serious sight-threatening complication of uveitis. It can occur in any anatomical type of uveitis. Our cohort showed increased incidence of i-CNV in patients with anterior and intermediate uveitis compared to previous reports. Furthermore, the less frequent type 3 CNV was seen among our patents.
