Systemic Immunosuppression Is Highly Effective in the Long-term Control of Inflammatory non-infectious Uveitic Choroidal Neovascularization: A Comparative Study

Ocul Immunol Inflamm. 2021 Aug 18;29(6):1132-1136. doi: 10.1080/09273948.2020.1727530. Epub 2020 Apr 7.

Abstract

Purpose: To compare immediate versus delayed introduction of immunosuppressives for naive noninfectious inflammatory choroidal neovascularization (iCNV).Methods: a retrospective, consecutive, comparative, interventional case series of patients with a diagnosis of inflammatory CNV and a minimum follow of 36 months. Patients were divided into two groups: Group A received Immunosuppressives if needed, while Group B since baseline. Both groups received systemic steroids and intravitreal ranibizumab since baseline. Primary end point was to compare the BCVA outcome till 36-month follow-up.Results: Twenty-nine eyes with iCNV were enrolled. In the long term, best-corrected visual acuity (BCVA) was significantly better in group B. At 3-month follow-up, Group B reduced steroids <10 mg/day significantly (p = .0001, Fisher's Exact Test). At 36 months of follow up, injections given were 2.9 (0.9 SD) in group A and 1.25 (0.4 SD) in group B.Conclusion: early immunosuppressive therapy exerts a positive action on the long-term control of uveitic CNV.

Keywords: Uveitis; anti-vascular endothelial growth factor; choroidal neovascularization; immunesuppressive drugs; steroids.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / therapeutic use*
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / physiopathology
  • Choroiditis / diagnosis
  • Choroiditis / drug therapy*
  • Choroiditis / physiopathology
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Intravitreal Injections
  • Male
  • Ranibizumab / therapeutic use*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Uveitis / diagnosis
  • Uveitis / drug therapy*
  • Uveitis / physiopathology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

  • Angiogenesis Inhibitors
  • Glucocorticoids
  • Immunosuppressive Agents
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Ranibizumab