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Zaslavsky K, Park T, Lang Mcinnis R, Mandell M, Lee J, Lee C, Gilbert R, Derzko-Dzulynsky L. Outcomes in PIC-Related CNV: Pooled Analysis of Individual Participant Data. Ocul Immunol Inflamm 2023; 31:1825-1836. [PMID: 36179037 DOI: 10.1080/09273948.2022.2124176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 09/06/2022] [Indexed: 10/14/2022]
Abstract
Choroidal neovascularization (CNV) affects 64-75% of eyes with punctate inner choroidopathy (PIC). Although anti-VEGF agents are considered first-line therapy, there is controversy regarding other modalities, such as immunosuppression. We performed a systematic review of individual participant data (IPD) and generated a dataset of 278 eyes with PIC-related CNV from 45 studies. Forty-two percent presented with moderate visual loss (MVL) or worse. Four different treatment modalities (anti-VEGF, photodynamic therapy, local immunosuppression, and systemic immunosuppression) and most combinations among them were represented. Anti-VEGF injections decreased the likelihood of MVL (Odds Ratio 0.3, p = .027), an effect moderated by presenting visual acuity and patient age. Eyes receiving more than 3 injections were more likely to receive additional therapeutic modalities. Increasing number of modalities was associated with longer follow-up time and did not improve vision. The beneficial effect of anti-VEGF injections persisted when controlling for presenting visual acuity and follow-up time.
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Affiliation(s)
- Kirill Zaslavsky
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Teresa Park
- Department of Ophthalmology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Rachel Lang Mcinnis
- Department of Ophthalmology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Mark Mandell
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jihwan Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Christopher Lee
- Department of Ophthalmology, The Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Rose Gilbert
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
- National Institute for Health Research Moorfields Biomedical Research Centre, London, UK
- Addenbrooke's Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - Larissa Derzko-Dzulynsky
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Visusverschlechterung und Metamorphopsien bei einer jungen Patientin. Ophthalmologe 2014; 111:373-5. [DOI: 10.1007/s00347-013-2952-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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