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Research article
Lin Zhao
Peking University Third Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8038-0880
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
This study aimed to evaluate the visual and morphological outcomes of intravitreal anti-VEGF therapy and the recurrence for idiopathic choroidal neovascularization (ICNV).
Methods
This retrospective study included 35 patients (35 eyes) with ICNV from July 2012 to October 2017. All patients received 1 intravitreal anti-VEGF injection followed by pro re nata injections until there was no sign of ICNV activity. This was defined as the first follow-up period. To evaluate ICNV recurrence, we continued to follow-up 27 of the 35 patients for at least 2 years after the initial diagnosis, and the longest follow-up period was 5 years. Additional injection was performed when ICNV recurred. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded and morphological improvement in optical coherence tomography (OCT) was assessed. Parameters that affect prognosis and recurrence were analysed.
Results
The mean follow-up period was 168.0 ± 34.82 weeks. Mean BCVA improved from 56.20 ± 14.13 letters at baseline to 73.31 ± 12.57 letters (P＜0.01); Mean CRT decreased from 353.6 ± 98.70 μm at baseline to 273.1 ± 53.56 μm (P < 0.001) at the end of the first follow-up period. Better baseline BCVA indicated a better morphological improvement(P = 0.026) in OCT: the lesion had completely subsided with recovery of the foveal contour. Those with high baseline BCVA (more than 60 letters) showed significant resolution of CNV lesions (P = 0.036). ICNV recurred in six patients (22.2%), 1 of whom experienced 2 recurrences. The mean timing of recurrence was 90.83± 49.02 weeks after diagnosis. There was no significant correlation between ICNV recurrence and the morphological improvement (P = 0.633). The final BCVA in patients with recurrence did not differ from that in patients without recurrence (P=0.065).
Conclusions
Intravitreal anti-VEGF therapy on a pro re nata basis was effective for treating ICNV. High baseline BCVA indicated a better prognosis. Re-treatment with anti-VEGF could effectively lead to resolution of recurrent ICNV. Disease recurrence had no significant effect on final visual prognosis and had no correlation with the morphological improvement during treatment, suggesting that follow-up for subsequent monitoring should be performed in all ICNV patients.
Keywords
Idiopathic choroidal neovascularization; Intravitreal injection; Anti-VEGF therapy; Prognosis; Recurrence.
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Posted 17 Mar, 2020
No community comments so far
Reviewers invited
Invitations sent on 12 Mar, 2020
Reviewer #1 agreed
On 12 Mar, 2020
Review #1 received
Received 12 Mar, 2020
Editor assigned
On 10 Mar, 2020
Submission checks complete
On 09 Mar, 2020
Editor invited
On 09 Mar, 2020
No comments provided
Editorial decision: Major revision
On 23 Feb, 2020
Review #1 received
Received 10 Feb, 2020
Reviewer #2 agreed
On 09 Feb, 2020
Reviewer #3 agreed
On 09 Feb, 2020
Review #2 received
Received 09 Feb, 2020
Reviewer #1 agreed
On 06 Feb, 2020
Reviewers invited
Invitations sent on 01 Feb, 2020
Editor assigned
On 21 Jan, 2020
Submission checks complete
On 21 Jan, 2020
Editor invited
On 20 Jan, 2020
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Subject Areas
Ophthalmology
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This preprint is under consideration at BMC Ophthalmology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Lin Zhao
Peking University Third Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8038-0880
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 2
Posted 17 Mar, 2020
No community comments so far
Reviewers invited
Invitations sent on 12 Mar, 2020
Reviewer #1 agreed
On 12 Mar, 2020
Review #1 received
Received 12 Mar, 2020
Editor assigned
On 10 Mar, 2020
Submission checks complete
On 09 Mar, 2020
Editor invited
On 09 Mar, 2020
No comments provided
Editorial decision: Major revision
On 23 Feb, 2020
Review #1 received
Received 10 Feb, 2020
Reviewer #2 agreed
On 09 Feb, 2020
Reviewer #3 agreed
On 09 Feb, 2020
Review #2 received
Received 09 Feb, 2020
Reviewer #1 agreed
On 06 Feb, 2020
Reviewers invited
Invitations sent on 01 Feb, 2020
Editor assigned
On 21 Jan, 2020
Submission checks complete
On 21 Jan, 2020
Editor invited
On 20 Jan, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Ophthalmology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
This study aimed to evaluate the visual and morphological outcomes of intravitreal anti-VEGF therapy and the recurrence for idiopathic choroidal neovascularization (ICNV).
Methods
This retrospective study included 35 patients (35 eyes) with ICNV from July 2012 to October 2017. All patients received 1 intravitreal anti-VEGF injection followed by pro re nata injections until there was no sign of ICNV activity. This was defined as the first follow-up period. To evaluate ICNV recurrence, we continued to follow-up 27 of the 35 patients for at least 2 years after the initial diagnosis, and the longest follow-up period was 5 years. Additional injection was performed when ICNV recurred. Best corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded and morphological improvement in optical coherence tomography (OCT) was assessed. Parameters that affect prognosis and recurrence were analysed.
Results
The mean follow-up period was 168.0 ± 34.82 weeks. Mean BCVA improved from 56.20 ± 14.13 letters at baseline to 73.31 ± 12.57 letters (P＜0.01); Mean CRT decreased from 353.6 ± 98.70 μm at baseline to 273.1 ± 53.56 μm (P < 0.001) at the end of the first follow-up period. Better baseline BCVA indicated a better morphological improvement(P = 0.026) in OCT: the lesion had completely subsided with recovery of the foveal contour. Those with high baseline BCVA (more than 60 letters) showed significant resolution of CNV lesions (P = 0.036). ICNV recurred in six patients (22.2%), 1 of whom experienced 2 recurrences. The mean timing of recurrence was 90.83± 49.02 weeks after diagnosis. There was no significant correlation between ICNV recurrence and the morphological improvement (P = 0.633). The final BCVA in patients with recurrence did not differ from that in patients without recurrence (P=0.065).
Conclusions
Intravitreal anti-VEGF therapy on a pro re nata basis was effective for treating ICNV. High baseline BCVA indicated a better prognosis. Re-treatment with anti-VEGF could effectively lead to resolution of recurrent ICNV. Disease recurrence had no significant effect on final visual prognosis and had no correlation with the morphological improvement during treatment, suggesting that follow-up for subsequent monitoring should be performed in all ICNV patients.
Figure 1
Figure 2
Figure 3
Figure 4
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