Cem Ozgonul1, Omar Moinuddin, Metasebia Munie, Michael S Lee, M Tariq Bhatti, Klara Landau, Gregory P Van Stavern, Devin D Mackay, Maud Lebas, Lindsey B DeLott, Wayne T Cornblath, Cagri G Besirli. 1. Department of Ophthalmology (CO), Gulhane Training and Research Hospital, Ankara, Turkey; Department of Ophthalmology and Visual Sciences (OM, LBD, WTC, CGB), W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan; Department of Ophthalmology (MM), Mid-Atlantic Permanente Medical Group, Rockville, Maryland; Department of Ophthalmology and Visual Neurosciences (MSL), University of Minnesota, Minneapolis, Minnesota; Department of Ophthalmology and Neurology Mayo Clinic (MTB), Rochester, Minnesota; Department of Ophthalmology (KL), University Hospital Zurich and University of Zurich, Zurich, Switzerland; Department of Ophthalmology (GPVS), Washington University in St. Louis, St. Louis, Missouri; Department of Ophthalmology (DDM), Indiana University School of Medicine, Indianapolis, Indiana; Department of Ophthalmology (ML), Hôpital Delafontaine, Saint-Denis, France; and Department of Neurology (LBD, WTC), University of Michigan, Ann Arbor, Michigan.
Abstract
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.
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.
Authors: Michel J Belliveau; Lin Xing; David R P Almeida; Jeffrey S Gale; Martin W ten Hove Journal: J Neuroophthalmol Date: 2013-03 Impact factor: 3.042
Authors: Susan P Mollan; Keira A Markey; James D Benzimra; Andrew Jacks; Tim D Matthews; Michael A Burdon; Alex J Sinclair Journal: Pract Neurol Date: 2014-05-08