Tanya, Balakrishnan (2020) Inflammatory Choroidal Neovascular Membrane-Incidence, Visual and Anatomical Outcomes after Intravitreal Anti-Vascular Endothelial Growth Factor Therapy. Masters thesis, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Madurai.
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Abstract
INTRODUCTION: Choroidal neovascularization(CNVM) is the formation of new blood vessels beneath the retina, originating from the choroid. Various etiologies can cause CNVM, most common being age-related macular degeneration (ARMD) followed by pathological myopia and inflammatory CNVM. In uveitis, because of the association with various inflammatory conditions of the posterior segment, CNVMs formed are termed as “inflammatory CNVM”. Common causes of inflammatory CNVM in India are idiopathic, infectious causes like ocular tuberculosis, and Vogt-Koyanagi-Harada (VKH) syndrome, some other etiologies being multifocal choroiditis, punctate inner choroidopathy (PIC), ocular histoplasmosis syndrome, etc. Inflammatory CNVM is a rare but major vision threatening complication of active or inactive uveitis, with no uniform consensus for the treatment. CNV can occur in the sub-foveal, juxta-foveal or peripapillary locations, with sub-foveal CNV having the most guarded prognosis, while variable outcomes are noted in the other two types. CNV caused due to inflammatory causes are mostly Type 2 or classic CNV, which occupies the sub-neurosensory compartment between RPE and outer-segments of the retina. OBJECTIVES: To analyse the visual & anatomical outcomes post Intravitreal Anti-VEGF injections in patients with Inflammatory Choroidal Neovascular Membranes. METHODOLOGY: Tertiary care centre-based prospective, nonrandomized study. All patients diagnosed with CNVM in cases of active or resolved uveitis were treated with Anti-VEGF. OUTCOME MEASURES: Improvement of Best corrected visual acuity, Decrease in central macular thickness(CMT) on OCT and resolution of sub retinal fluid(SRF) at six month follow-up. RESULTS: The study included 18cases. Ocular TB (33%), Sarcoid (27%) idiopathic(16.6%) were the common causes. At the end of 6 months with a mean of 2.6 injections the BCVA improved from a mean of 0.7±0.42(6/36) to 0.295± 0.19(6/12), with a reduction in mean CMT from 448.8µ ±97.7 to 347µ ±145 and complete resolution of SRF in 80% of cases with recurrence in 2 cases having active uveitis. CONCLUSIONS: Anti-VEGF is effective for the treatment of Uveitic CNV with a low recurrence rate and no major complications.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 221713454 |
| Uncontrolled Keywords: | Inflammatory Choroidal Neovascular Membrane-Incidence, Visual and Anatomical Outcomes, Intravitreal Anti-Vascular Endothelial Growth Factor Therapy. |
| Subjects: | MEDICAL > Ophthalmology |
| Depositing User: | Subramani R |
| Date Deposited: | 14 Feb 2021 16:02 |
| Last Modified: | 14 Feb 2021 16:02 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/14205 |
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