Subretinal neovascular membranes complicating uveitis: frequency, treatments, and visual outcome.

Détails

ID Serval
serval:BIB_5241A6E8BCDD
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Subretinal neovascular membranes complicating uveitis: frequency, treatments, and visual outcome.
Périodique
Ocular Immunology and Inflammation
Auteur(s)
Perentes Y., Van Tran T., Sickenberg M., Herbort C.P.
ISSN
0927-3948 (Print)
ISSN-L
0927-3948
Statut éditorial
Publié
Date de publication
2005
Peer-reviewed
Oui
Volume
13
Numéro
2-3
Pages
219-224
Langue
anglais
Notes
Publication types: Case Reports ; Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
PURPOSE: Retrospective evaluation in a uveitic population of subretinal neovascular membranes (SRNMs), their occurrence, visual impact, and outcome in differently treated subgroups of patients.
METHODS: Medical records of patients were reviewed and cases with SRNM (n = 12) identified. Intraocular inflammation was classified according to vitreous examination records as high (2+ cells), low (1/2+ to 1+ cells), or inactive (0 cells). Visual outcome was considered to be +VA (same or gain of one or more Snellen lines) or -VA (loss of Snellen lines). In nine cases, treatment consisted of the oral administration of high doses of corticosteroids (CST) for one month, tapered down in favorable situations (+VA or SRNM angiographic regression) or maintained at half the dose in unfavorable situations (-VA or SRNM angiographic progression) while additional laser therapies, including photodynamic therapy (PDT), transpupillary thermotherapy (TTT), or argon laser therapy (CLT)), were performed in some of the cases. The above treatment scheme was not applied in three cases (pre-PDT period; undiagnosed underlying uveitis treated without CST).
RESULTS: Twelve out of 648 patients (1.9%) with uveitis developed SRNM. The mean visual impact was 4.5 Snellen lines and mean follow-up time was 19.5 months. Two patients with high intraocular inflammation had a favorable visual outcome with CST alone. Eight patients with low intraocular inflammation had a favorable visual outcome with CST alone in three cases, with additional laser therapy in four cases (PDT in 3 cases and TTT in 1 case), and exclusively with PDT in one case (undiagnosed uveitis). Two patients with no intraocular inflammation had unfavorable visual outcome with CST alone (no PDT/TTT available).
CONCLUSION: SRNMs occurred as a rare complication of uveitis. Their visual outcome was relatively favorable. Although high doses of CST seem to be the first step in the management of SRNMs, alternative laser treatments should be considered early, especially in cases of absence or low intraocular inflammation.
Mots-clé
Adolescent, Adult, Aged, Disease Progression, Female, Fluorescein Angiography, Follow-Up Studies, Fundus Oculi, Glucocorticoids/therapeutic use, Humans, Hyperthermia, Induced/methods, Incidence, Laser Coagulation/methods, Male, Middle Aged, Photochemotherapy/methods, Retina/pathology, Retinal Neovascularization/epidemiology, Retinal Neovascularization/etiology, Retrospective Studies, Switzerland/epidemiology, Treatment Outcome, Uveitis/complications, Uveitis/diagnosis, Visual Acuity/physiology
Pubmed
Création de la notice
01/07/2016 11:35
Dernière modification de la notice
03/03/2018 17:13
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