Treatment of Inflammatory Choroidal Neovascular Membranes
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Choroidal neovascularization (CNV) represents a severe sight-threatening occurrence in patient with inflammation of the uveal tract. CNV might can be secondary to both infectious and noninfectious uveitis.
After an appropriate assessment of the uveal inflammation by fluorescein angiography (FA), indocyanine green angiography (ICGA) and optical coherence tomography (OCT) and OCT angiography, a prompt and effective therapeutic strategy has to be planned.
Infectious uveitis complicated by CNV has to treated by targeting the infectious disease itself primarily and by associating therapies directly targeting the neovascular process, such as the intravitreal anti-Vascular Endothelial Growth Factor (VEGF) agents. In specific cases, an adjuvant therapy by steroids might appropriate.
The treatment strategy for CNV secondary to noninfectious uveitis should aim primarily the control of the inflammation control. The association of steroids with immunosuppressive agents is most appropriate therapy for inflammatory CNV. Anti-VEGF agents are commonly associated with systemic therapy.
Although there is no comparative study between immunosuppressive agents, mycophenolate mofetil seems to offer a promising profile for the long term control of non-infectious inflammatory CNV.
Although a series of publications reported different treatment strategies for inflammatory neovascularization, there is no guideline available till now.
KeywordsInflammatory choroidal neovascularization Uveitis Immunosuppression Steroids Anti VEGF
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