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Management of Peripapillary Choroidal Neovascular Membrane in Patients With Idiopathic Intracranial Hypertension.

Authors :
Ozgonul C
Moinuddin O
Munie M
Lee MS
Bhatti MT
Landau K
Van Stavern GP
Mackay DD
Lebas M
DeLott LB
Cornblath WT
Besirli CG
Source :
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society [J Neuroophthalmol] 2019 Dec; Vol. 39 (4), pp. 451-457.
Publication Year :
2019

Abstract

Objective: To report the clinical features and treatment outcomes of patients with peripapillary choroidal neovascular membrane (CNVM) secondary to idiopathic intracranial hypertension (IIH).<br />Methods: Retrospective, multicenter chart review of patients diagnosed with peripapillary CNVM in the course of the treatment and follow-up of IIH.<br />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.<br />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.

Details

Language :
English
ISSN :
1536-5166
Volume :
39
Issue :
4
Database :
MEDLINE
Journal :
Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society
Publication Type :
Academic Journal
Accession number :
30951011
Full Text :
https://doi.org/10.1097/WNO.0000000000000781