scholarly journals Long-Term Follow-Up of Polypoidal Choroidal Vasculopathy Secondary to Angioid Streaks Treated by Intravitreal Aflibercept and Ranibizumab

2017 ◽  
Vol 8 (1) ◽  
pp. 221-231 ◽  
Author(s):  
James G. Wong ◽  
Katherine Yu Qian
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Angioid Streaks ◽  
Case Review ◽  
Retrospective Case ◽  
Treat And Extend ◽  
Anti Vegf ◽  
Intravitreal Aflibercept ◽  
Choroidal Vasculopathy

Purpose: Angioid streaks (AS) are dehiscences in Bruch’s membrane that may be idiopathic or associated with numerous systemic illnesses. Polypoidal choroidal vasculopathy (PCV) is an underdiagnosed exudative chorioretinopathy often characterised by serosanguineous detachments of the pigmented epithelium. The use of the anti-VEGF agents ranibizumab and aflibercept in the management of PCV secondary to AS has not been previously documented. We report 3 patients with active PCV secondary to AS, 1 of which had a family history of PCV secondary to AS, not previously reported in the literature. All patients were symptomatic and treated with intravitreal anti-VEGF therapy with and without combination photodynamic therapy (PDT). Methods: This is a long-term retrospective case review of 3 eyes of 3 patients with AS and clinical features of PCV. The patients were examined using fundoscopy, spectral domain optical coherence tomography, fluorescein angiography, and indocyanine green angiography. All patients were managed with intravitreal anti-VEGF using a treat-and-extend protocol according to specific retreatment criteria. One patient had 1 session of PDT in combination with anti-VEGF injections. Results: The mean follow-up time in all patients was 4 years. In all 3 cases, the treatment resulted in improved visual acuity and regression of active PCV lesions with a longer duration between injections. Conclusion: The treat-and-extend protocol with intravitreal aflibercept or ranibizumab with or without PDT is effective and safe for PCV secondary to AS.

scholarly journals Packing density and long-term occlusion after transcatheter vessel embolization with soft, bare-platinum detachable coils

2020 ◽  
Vol 4 ◽  
pp. 2
Author(s):  
James Vogler IV ◽  
Mark Gemender ◽  
Dmitri Samoilov
Keyword(s):  
Packing Density ◽  
Hepatic Arterial Infusion ◽  
Case Review ◽  
Technical Success ◽  
Retrospective Case ◽  
Infusion Chemotherapy ◽  
Patient Demographics ◽  
Detachable Coils

Objective: The objective of this study was to examine packing density and long-term recanalization rates after embolization with soft, bare-platinum ruby coils in the gastroduodenal artery (GDA). Materials and Methods: Retrospective case review of patients with hepatic malignancy who underwent coil occlusion of the GDA for radioembolization or hepatic arterial infusion chemotherapy between November 2013 and July 2018. Data on patient demographics, GDA diameter, length of coil pack, and distance between GDA origin and most proximal coil were collected. Packing density was calculated as the ratio between the volume of inserted coils and the volume of the vessel area that were filled with coil. The primary outcome was the rate of GDA recanalization, determined by review of hepatic arteriograms at follow-up. Results: Long-term occlusion free of recanalization was observed in 97.8% (88/90) of patients over a median follow-up time of 13.4 ± 11.3 months. Median vessel packing density was 55% (interquartile range 41–71) and procedural technical success was achieved in 100% (90/90) of patients. Of the 90 patients (72 men; mean age 63.8 ± 7.5 years), mean GDA diameter was 4.0 ± 0.8 mm and the proximal coil distance from GDA origin was 8.6 ± 3.0 mm. Mean coil pack length was 21.2 ± 7.6 mm. Recanalization occurred in 2.2% (2/90) of patients. No increase in recanalization rates with distal coil placement was observed. Conclusions: The study demonstrates high levels of technical success and low rates of recanalization (2.2%) when high packing densities (55%) are achieved using soft, bare-platinum ruby coils. The rate of recanalization at follow-up compares favorably to previously reported literature.

Long-Term Follow-Up of Choroidal Neovascularization due to Angioid Streaks with pro re nata Intravitreal Anti-VEGF Treatment

2017 ◽  
Vol 238 (1-2) ◽  
pp. 44-51 ◽  
Author(s):  
Giovanni Giacomelli ◽  
Lucia Finocchio ◽  
Ilaria Biagini ◽  
Andrea Sodi ◽  
Vittoria Murro ◽  
...  
Keyword(s):  
Choroidal Neovascularization ◽  
Angioid Streaks ◽  
Anti Vegf ◽  
Long Term Follow Up ◽  
Pro Re Nata

scholarly journals Long-term outcomes of focal laser photocoagulation for the treatment of polypoidal choroidal vasculopathy

2021 ◽  
Vol 14 (9) ◽  
pp. 1402-1407
Author(s):  
Sooyeon Choe ◽  
◽  
Kyu Hyung Park ◽  
Christopher Seungkyu Lee ◽  
Se Joon Woo ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Laser Photocoagulation ◽  
Visual Outcome ◽  
Post Treatment ◽  
Focal Laser Photocoagulation ◽  
Before And After ◽  
Photocoagulation Treatment ◽  
Choroidal Vasculopathy

AIM: To evaluate the long-term effect and safety of focal laser photocoagulation treatment in eyes with polypoidal choroidal vasculopathy (PCV). METHODS: Medical records of 13 eyes of 13 patients with PCV were followed-up for more than 2y after focal laser photocoagulation treatment. The patients were diagnosed with PCV using indocyanine green angiography, and eyes with other comorbid ocular diseases were excluded. The measurement outcomes of the study were the post-treatment regression and recurrence of polyps, complications, and changes in visual acuities. Paired t-test was performed to compare visual outcome before and after the treatment. RESULTS: The mean age of the 13 patients was 70.2±5.5y, and the follow-up period was 72.3±31.0 (range, 25-118)mo. Three eyes had juxtafoveal polyps and 10 eyes had extrafoveal polyps. Of the 13 eyes, 9 eyes (69.2%) had regression of polyps 1.7±1.2 (range, 0.9-4)mo after focal laser photocoagulation. Five eyes (55.6%) showed recurrence of polyps during the follow-up periods, and the recurrence period was 12.8±18.9 (range, 1.9-48)mo. Mild subretinal hemorrhage occurred in two eyes (15.4%) 27 and 72d after laser treatment, respectively. There were no statistically significant differences in visual acuities at baseline; 1, 2, 3y post-treatment (all P>0.05); and last follow-up (0.63±0.5, 0.73±0.70, 0.67±0.57, 0.75±0.7, and 0.95±0.8 logMAR, respectively). CONCLUSION: Focal laser photocoagulation is beneficial for early regression of polyps in eyes with PCV and does not result in significant submacular hemorrhage during the long-term follow-up. Furthermore, it can be primarily considered in eyes with PCV with extrafoveal or juxtafoveal polyps to regress risky polyps as well as to maintain visual acuity without serious hemorrhagic complications.

Long-term results of photodynamic therapy or ranibizumab for polypoidal choroidal vasculopathy in LAPTOP study

2018 ◽  
Vol 103 (6) ◽  
pp. 844-848 ◽  
Author(s):  
Noriko Miyamoto ◽  
Michiko Mandai ◽  
Akio Oishi ◽  
Shunichiro Nakai ◽  
Shigeru Honda ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Polypoidal Choroidal Vasculopathy ◽  
Long Term Results ◽  
Intravitreal Ranibizumab ◽  
Macular Atrophy ◽  
Long Term Effect ◽  
First Choice ◽  
Choroidal Vasculopathy

Background/aimWe previously reported that ranibizumab performed better on visual prognosis than photodynamic therapy (PDT) in a Ranibizumab (Lucentis) And Photodynamic Therapy On Polypoidal choroidal vasculopathy (LAPTOP) study. To determine if the first-choice treatment, either PDT or intravitreal ranibizumab, has a long-term effect in patients with polypoidal choroidal vasculopathy (PCV).MethodsWe reviewed medical records of patientsrandomised to either PDT (29 eyes) or ranibizumab (27 eyes) from July 2009 to June 2011 in LAPTOP study. Retreatment or switching to other treatments were at the investigator’s discretion after release from the 2-year LAPTOP study up to 5years. We evaluated visual acuity (VA), continuity of initial treatment, percentage of dry macula achievement and macular atrophy at 5 years.ResultsThe logarithm of minimal angle of resolution VA was 0.56 in the PDT and 0.44 in the ranibizumab groups at baseline (p=0.101) and was 0.55 and 0.28 at 5years, respectively (p<0.05). More than 70% of the patients converted to aflibercept in following years. Achievement percentages of dry macula were 74% (PDT) and 63% (ranibizumab) at 5years, and macular atrophy was detected in 78% (PDT) and 60% (ranibizumab) with a mean area of 7.7 and 3.5 mm2, respectively (p=0.155).ConclusionsThe better VA in the initial ranibizumab group compared with the PDT group at 2 years was retained at the 5-year follow-up.

scholarly journals Comparison of Outcomes between 3 Monthly Brolucizumab and Aflibercept Injections for Polypoidal Choroidal Vasculopathy

Biomedicines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1164
Author(s):  
Yoshiko Fukuda ◽  
Yoichi Sakurada ◽  
Mio Matsubara ◽  
Yuka Hasebe ◽  
Atsushi Sugiyama ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Retinal Thickness ◽  
Treated Group ◽  
Short Term ◽  
Corrected Visual Acuity ◽  
Intravitreal Aflibercept ◽  
Treatment Naïve ◽  
Choroidal Vasculopathy ◽  
Selection Of

We compared the short-term outcomes between 3-monthly aflibercept and brolucizumab injections for treatment-naïve polypoidal choroidal vasculopathy (PCV). A total of 52 eyes were included. Patients received 3 monthly intravitreal aflibercept (n = 38) or intravitreal brolucizumab (n = 14). Indocyanine green angiography (ICGA) was performed at baseline and at the 3-month visit. Selection of anti-VEGF agents depended on time. In the brolucizumab-treated group, best-corrected visual acuity (BCVA) improved from 0.27 ± 0.34 (log MAR unit) at baseline to 0.20 ± 0.24 at 3-month visit, which is comparable with the aflibercept-treated group (p = 0.87), after adjustment of confounding factors. Central retinal thickness significantly decreased by 43%−44% in both groups. Subfoveal choroidal thickness also significantly decreased by 20.5% during this interval in the brolucizumab-treated group, which was greater than the aflibercept-treated group. The complete resolution rate of polypoidal lesions on ICGA was significantly higher (p = 0.043) in the brolucizumab-treated group (78.6%) than in the aflibercept-treated group (42.1%). Intraocular inflammation was observed in 14.3% (2/14) in the brolucizumab-treated group only. In short-term follow-up, intravitreal injection of 3-monthly brolucizumab was comparable with aflibercept in terms of BCVA and morphological improvement along with higher resolution of polypoidal lesion(s) on ICGA.

scholarly journals Polypoidal Choroidal Vasculopathy after Stereotactic Radiotherapy for Neovascular Age-Related Macular Degeneration: A Case Report with Long-Term Follow-Up

2021 ◽  
Vol 12 (1) ◽  
pp. 299-305
Author(s):  
Alexandra Steinemann ◽  
Laura Hoffmann ◽  
Katja B. Hatz
Keyword(s):  
Macular Degeneration ◽  
Stereotactic Radiotherapy ◽  
Low Dose ◽  
Age Related Macular Degeneration ◽  
Anti Vegf ◽  
Age Related ◽  
Long Term Follow Up ◽  
Choroidal Vasculopathy

Several adjunct therapies to the gold standard anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections have been discussed for the treatment of neovascular age-related macular degeneration (nAMD). Low-dose stereotactic radiotherapy (SRT) showed the potential to lower the treatment burden by reducing the anti-VEGF treatment frequency at least over 2–3 years but was associated with retinal microvascular abnormalities in a few cases. We report a 6-year follow-up of a case with bilateral nAMD under anti-VEGF treatment which developed multiple polypoid choroidal vasculopathy (PCV) lesions in the eye adjunct treated with low-dose SRT. The fellow eye suffering from nAMD for the same period of time but never been treated with SRT did not show PCV during the long-term follow-up. We hope to increase the awareness of possible choroidal changes such as PCV in similar patients by sharing this report.

scholarly journals One-year outcomes of a treat-and-extend regimen of intravitreal aflibercept for polypoidal choroidal vasculopathy

2016 ◽  
Vol 61 (2) ◽  
pp. 150-158 ◽  
Author(s):  
Mio Hosokawa ◽  
Yuki Morizane ◽  
Masayuki Hirano ◽  
Shuhei Kimura ◽  
Fumiaki Kumase ◽  
...  
Keyword(s):  
Polypoidal Choroidal Vasculopathy ◽  
Treat And Extend ◽  
Intravitreal Aflibercept ◽  
One Year ◽  
Choroidal Vasculopathy ◽  
Treat And Extend Regimen
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