Journal article
Management of Peripapillary Choroidal Neovascular Membrane in Patients With Idiopathic Intracranial Hypertension.
- Ozgonul C Department of Ophthalmology (CO), Gulhane Training and Research Hospital, Ankara, Turkey; Department of Ophthalmology and Visual Sciences (OM, LBD, WTC, CGB), W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; Department of Ophthalmology (MM), Mid-Atlantic Permanente Medical Group, Rockville, Maryland; Department of Ophthalmology and Visual Neurosciences (MSL), University of Minnesota, Minneapolis, Minnesota; Department of Ophthalmology and Neurology Mayo Clinic (MTB), Rochester, Minnesota; Department of Ophthalmology (KL), University Hospital Zurich and University of Zurich, Zurich, Switzerland; Department of Ophthalmology (GPVS), Washington University in St. Louis, St. Louis, Missouri; Department of Ophthalmology (DDM), Indiana University School of Medicine, Indianapolis, Indiana; Department of Ophthalmology (ML), Hôpital Delafontaine, Saint-Denis, France; and Department of Neurology (LBD, WTC), University of Michigan, Ann Arbor, Michigan.
- Moinuddin O
- Munie M
- Lee MS
- Bhatti MT
- Landau K
- Van Stavern GP
- Mackay DD
- Lebas M
- DeLott LB
- Cornblath WT
- Besirli CG
- 2019-04-06
Published in:
- Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society. - 2019
Acetazolamide
Adolescent
Adult
Angiogenesis Inhibitors
Carbonic Anhydrase Inhibitors
Choroidal Neovascularization
Female
Fluorescein Angiography
Humans
Intravitreal Injections
Male
Middle Aged
Optic Disk
Pseudotumor Cerebri
Retrospective Studies
Tomography, Optical Coherence
Vascular Endothelial Growth Factor A
Visual Acuity
Young Adult
English
OBJECTIVE
To report the clinical features and treatment outcomes of patients with peripapillary choroidal neovascular membrane (CNVM) secondary to idiopathic intracranial hypertension (IIH).
METHODS
Retrospective, multicenter chart review of patients diagnosed with peripapillary CNVM in the course of the treatment and follow-up of IIH.
RESULTS
Records were reviewed from 7 different institutions between 2006 and 2016. Ten patients (13 eyes) with a diagnosis of IIH and at least 3 months of follow-up developed CNVM. Three of the total 10 patients developed bilateral CNVM. The mean time from the diagnosis of IIH to CNVM diagnosis was 41 months. Mean follow-up period was 8 months after diagnosis of CNVM. All patients were treated with acetazolamide for IIH. Seven eyes were observed, and 6 eyes were given anti-vascular endothelial growth factor (anti-VEGF) injections, including bevacizumab, ranibizumab, and aflibercept. All CNVMs regressed with subretinal fibrosis, and visual acuity improved in most patients. Papilledema resolved in only 1 eye, while the other 12 eyes had persistent papilledema at last follow-up.
CONCLUSIONS
Peripapillary CNVM, a rare complication of IIH, often resolves spontaneously with treatment of IIH. In vision-threatening and/or persistent cases, intravitreal anti-VEGF treatment may be a safe and effective therapeutic option.
To report the clinical features and treatment outcomes of patients with peripapillary choroidal neovascular membrane (CNVM) secondary to idiopathic intracranial hypertension (IIH).
METHODS
Retrospective, multicenter chart review of patients diagnosed with peripapillary CNVM in the course of the treatment and follow-up of IIH.
RESULTS
Records were reviewed from 7 different institutions between 2006 and 2016. Ten patients (13 eyes) with a diagnosis of IIH and at least 3 months of follow-up developed CNVM. Three of the total 10 patients developed bilateral CNVM. The mean time from the diagnosis of IIH to CNVM diagnosis was 41 months. Mean follow-up period was 8 months after diagnosis of CNVM. All patients were treated with acetazolamide for IIH. Seven eyes were observed, and 6 eyes were given anti-vascular endothelial growth factor (anti-VEGF) injections, including bevacizumab, ranibizumab, and aflibercept. All CNVMs regressed with subretinal fibrosis, and visual acuity improved in most patients. Papilledema resolved in only 1 eye, while the other 12 eyes had persistent papilledema at last follow-up.
CONCLUSIONS
Peripapillary CNVM, a rare complication of IIH, often resolves spontaneously with treatment of IIH. In vision-threatening and/or persistent cases, intravitreal anti-VEGF treatment may be a safe and effective therapeutic option.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1097/WNO.0000000000000781
- PMID 30951011
- Persistent URL
- https://folia.unifr.ch/global/documents/47865
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