Long-term success treating inflammatory epiretinal neovascularization with immunomodulatory therapy

Graefes Arch Clin Exp Ophthalmol. 2022 Feb;260(2):553-559. doi: 10.1007/s00417-021-05396-6. Epub 2021 Sep 9.

Abstract

Purpose: This study aims to report the long-term outcomes of uveitis-associated optic disc and epiretinal neovascularization (NV) treated with immunomodulatory therapy alone.

Methods: This is a retrospective, multi-center chart review conducted at Northwestern University (Chicago, IL) and San Raffaele Scientific Institute (Milan, Italy) from 2014 to 2021 of patients with optic disc and/or retinal neovascularization associated with uveitis. The data collected included age at the time of NV detection, gender, medications, and follow-up period. Imaging was reviewed if available.

Results: Eight eyes of six patients were identified. The mean age was 22 years (range 10-52 years); the median follow-up was 3 years (range 6 months to 7 years). All eyes presented with active NV at the time of uveitis onset; 7 eyes were treatment-naïve. None had clinical or angiographic evidence of retinal ischemia. All patients received a variable combination of local steroids, systemic steroids, and systemic immunosuppression. Complete resolution of uveitic NV occurred in all eyes within a median of 8 weeks (ranging 2-20 weeks) from initiating treatment. No NV recurrence was noted.

Conclusion: Immunomodulatory therapy alone may be successful in achieving long-term control of uveitis-associated NV, without the use of destructive measures.

Keywords: Immunomodulatory therapy; Inflammatory eye disease; Optic disc neovascularization; Retinal neovascularization; Uveitis.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Follow-Up Studies
  • Humans
  • Immunomodulation
  • Middle Aged
  • Optic Disk*
  • Retinal Neovascularization*
  • Retrospective Studies
  • Uveitis* / diagnosis
  • Uveitis* / drug therapy
  • Young Adult