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Evaluation of chorioretinal complex structure changes in patients with anti-VEGF resistant choroidal neovascularization


Purpose: to evaluate chorioretinal complex changes in patients with chorioretinal neovascularization and lack of anti-VEGF therapy effect, based on modern diagnostic methods in order to determine preferable treatment strategy. Methods: twenty one eyes of nineteen patients with diagnosis “choroidal neovascularisation” and lack of at least three intravitreal Ranibizumab injections effect were included in the study. They underwent comprehensive ophthalmic examination included best-corrected visual acuity (BCVA), microperimetry, central foveal thickness measurement by optical coherence tomography, autofluorescence, fluorescein angiography, indocyanine green angiography. The choroidal thickness was measured by enhanced depth imaging spectral-domain optical coherence tomography through the foveal center from the outer border of the retinal pigment epithelium to the inner scleral border. Results: according to the results of examination 4 patterns of chorioretinal complex pathologic changes were found: 1 – type 1 choroidal neovascularization; 2 – polypoidal choroidal vasculopathy; 3 – type 1 choroidal neovascularization and polyps combination; 4 – chronic central serous chorioretinopathy. Different pathogenetic base of detected patterns of chorioretinal changes may explain less effectiveness of anti-VEGF therapy. Conclusion: сomprehensive ophthalmic examination including evaluation of anatomic and functional chorioretinal changes enables to clarify the diagnosis and to determine preferable treatment strategy of patients with presumed choroidal neovascularization.


choroidal neovascularisation; polypoidal choroidal vasculopathy; chronic central serous chorio-retinopathy; anti-VEGF; choroidal thickness

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1. Solomin V.A. Sovremennye neinvazivnye metody diagnostiki i kombinirovannoe lechenie patsientov s submakulyaornoy neovaskulyarnoy membranoy. Avtoreferat dissertatsii ... kandidata meditsinskikh nauk. Moscow, 2014. 2. Doga A.V., Magaramov D.A., Solomin V.A. Diagnosticheskaya tsennost' izmereniya tolshchiny khorioidei u patsientov s subma-kulyarnoy neovaskulyarnoy membranoy. Oftal'mokhirurgiya – The Fyodorov Journal of Ophthalmic Surgery, 2014, no. 2, pp. 40-43. 3. Gass J.D. Stereoscopic atlas of macular diseases. 4th ed. St. Louis, Mosby Publ., 1997, pp. 26-30. 4. Yannuzzi L., Sorenson J., Spaide R., Lipson B. Idiopathic polypoidal choroidal vasculopathy (IPCV). Retina, 1990, no. 10 (1), pp. 1-8. DOI: 10.1097/00006982-199001010-00001. 5. Kokame G. Polypoidal Choroidal Vasculopathy – A Type I Polypoidal Subretinal Neovasculopathy. TOOPHTJ, 2013, no. 7 (1), pp. 82-84. DOI: 10.2174/1874364101307010082. 6. Hartnett M., Weiter J., Garsd A., Jalkh A. Classification of retinal pigment epithelial detachments associated with drusen. Graefe’s Archive for Clinical and Experimental Ophthalmology, 1992, no. 230 (1), pp. 11-19. DOI: 10.1007/bf00166756. 7. Yannuzzi L. Retinal angiomatous proliferation in age-related macular degeneration. Retina, 2002, no. 22 (4), pp. 511-512. DOI: 10.1097/00006982-200208000-00024. 8. Wang J., Wang E.Q., Chen Y.X., Tian R. Efficacy evaluation of photodynamic therapy and intravitreal anti-VEGF injection for polypoidalchoroidal vasculopathy: systematic review. Zhonghua Yan Ke Za Zhi, 2013, Dec., no. 49 (12), pp. 1094-1103. 9. Lim F.P., Wong C.W., Loh B.K., Chan C.M., Yeo I., Lee S.Y., Mathur R., Wong D., Wong T.Y., Cheung C.M. Prevalence and clinical correlates of focal choroidal excavation in eyes with age-related macular degeneration, polypoidal choroidal vasculopathy and central serous chorioretinopathy. Br. J. Ophthalmol., 2015, Oct. 26. PII: bjophthalmol-2015-307055. DOI: 10.1136/bjophthalmol-2015-307055. [Epub ahead of print]. PMID: 26504178. 10. Koh A. et al. Polypoidal choroidal vasculopathy: evidence-based guidelines for clinical diagnosis and treatment. Retina, 2013, Apr., no. 33 (4), pp. 686-716. DOI: 10.1097/IAE.0b013e3182852446. 11. Lambrozo B., Rispoli M. OKT setchatki. Metod analiza i interpretatsii. Moscow, April Publ., 2012. 83 p. 12. Serebryakov V.A., Boyko E.V., Yan A.V. Kogerentnaya tomografiya v diagnostike oftal'mologicheskikh zabolevaniy. St. Petersburg, 2013. 36 p. 13. Ulitina A.Yu., Izmaylov A.S. Otsenka tolshchiny khorioidei pri vozrastnoy makulyarnoy degeneratsii. Vestnik Orenburgskogo gosudarstvennogo universiteta – Vestnik of the Orenburg State University, 2013, no. 4, pp. 275-279. 14. Leung E.H., Rosen R.B. EDI- and SS-OCT imaging of the choroid. Retinal Physician, 2014, vol. 11, pp. 48, 50, 52, 53, 57, 58. 15. Spaide R.F., Koizumi H., Pozzoni M.C. Enhanced depth imaging spectral-domain optical coherence tomography. Am. J. Ophthalmol., 2008, vol. 146, no. 4. P. 496-500. 16. Kim S.W., Oh J., Kwon S.S., Yoo J. et al. Comparison of choroidal thickness among patients with healthy eyes, early age-related maculopathy, neovascular age-related macular degeneration, central serous chorioretinopathy, and polypoidal choroidal vasculopathy. Retina, 2011, vol. 31, no. 9, pp. 1904-1911. 17. Gallego-Pinazo R., Dolz-Marco R., Gumez-Ulla F., Mrejen S., Bailey Freund K. Pachychoroid diseases of the macula. Med. Hypothesis Discov. Innov. Ophthalmol., 2014, no. 3 (4), pp. 111-115. 18. Midena E. Microperimetry and multimodal retinal imaging. Berlin, Heidelberg, Springer-Verlag, 2014. 19. Daruich A1, Matet A1, Dirani Al et al. Central serous chorioretinopathy: Recent findings and new physiopathology hypothesis. Prog. Retin. Eye Res., 2015, Sep., vol. 48, pp. 82-118. DOI: 10.1016/j.preteyeres.2015.05.003.



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