TY - JOUR
T1 - Management of peripapillary choroidal neovascular membrane in patients with idiopathic intracranial hypertension
AU - Ozgonul, Cem
AU - Moinuddin, Omar
AU - Munie, Metasebia
AU - Lee, Michael S.
AU - Bhatti, M. Tariq
AU - Landau, Klara
AU - Van Stavern, Gregory P.
AU - Mackay, Devin D.
AU - Lebas, Maud
AU - Delott, Lindsey B.
AU - Cornblath, Wayne T.
AU - Besirli, Cagri G.
N1 - Publisher Copyright:
© North American Neuro-Ophthalmology Society. Unauthorized reproduction of this article is prohibited.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - 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.
AB - 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.
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U2 - 10.1097/WNO.0000000000000781
DO - 10.1097/WNO.0000000000000781
M3 - Article
C2 - 30951011
AN - SCOPUS:85075962967
SN - 1070-8022
VL - 39
SP - 451
EP - 457
JO - Journal of Neuro-Ophthalmology
JF - Journal of Neuro-Ophthalmology
IS - 4
ER -