Choroidal naevi complicated by choroidal neovascular membrane and outer retinal tubulation

Br J Ophthalmol. 2013 Aug;97(8):1014-9. doi: 10.1136/bjophthalmol-2013-303234. Epub 2013 May 18.

Abstract

Aims: To present the outcomes of a series of patients with choroidal neovascular membrane (CNV) secondary to a choroidal naevus and report the presence of outer retinal tubulation.

Methods: In this retrospective series, patients underwent a complete clinical and imaging assessment (fundus photo, fluorescein angiography and optical coherence tomography) and were observed or managed with intravitreal anti-VEGF injections dependent on whether visual acuity was affected.

Results: Seventeen patients were included in this study. Of this, 46% (8/17) had classic or predominantly classic CNV and 53% (9/17) had occult or minimally classic CNV. Active treatment with intravitreal anti-VEGF injections was required in 35% (6/17). Visual acuity improved in three eyes by 2-4 Snellen lines, remained stable in one eye and worsened in two eyes by 2 Snellen lines. CNV partially regressed in five cases. In the observation group (65%, 11/17), visual acuity did not change during follow-up period. Outer retinal tubulation was found in 18% (3/17).

Conclusions: Anti-VEGF treatment is effective in the management of vision threatening CNV secondary to a choroidal naevus. Functional or anatomical improvement was obtained in 66% of treated eyes. Outer retinal tubulation, noted in 18%, showed the clinical importance of this sign in determining continuation of anti-VEGF treatment.

Keywords: Choroid; Neoplasia; Neovascularisation.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Bevacizumab
  • Choroid Neoplasms / complications*
  • Choroid Neoplasms / drug therapy
  • Choroid Neoplasms / pathology
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / etiology*
  • Female
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Nevus, Pigmented / complications*
  • Nevus, Pigmented / drug therapy
  • Nevus, Pigmented / pathology
  • Ranibizumab
  • Retinal Diseases / diagnosis
  • Retinal Diseases / drug therapy
  • Retinal Diseases / etiology*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Ranibizumab