Management of inflammatory choroidal neovascular membranes

ABSTRACT

Introduction: Inflammatory choroidal neovascularization (iCNV) is a significant complication of uveitis, leading to vision loss in many cases. Recent advances in retinal imaging and the use of anti-vascular endothelial growth factor (VEGF) agents, have led to early diagnose and treatment, preventing visual deterioration.

Areas covered: This review discusses the epidemiology, pathogenesis, and conditions that are complicated by iCNV. We further describe diagnosis methods and treatment approaches to iCNV.

Expert opinion: Application of advanced retinal imaging techniques, including optical coherence tomography angiography, allows early diagnosis of iCNV, even before retinal damage has occurred. Early treatment with anti-VEGF together with immunosuppression agents results in rapid control of the iCNV, prevention of relapses, and vision loss.

KEYWORDS:

• Inflammatory choroidal neovascularization
• optical coherence tomography
• fluorescein angiography
• anti-vascular endothelial growth factor
• punctate inner choroidopathy
• multifocal choroiditis

Article highlights

• Choroidal neovascularisation (CNV) is a major sight-threatening complication of uveitis, and a leading cause of CNV after neovascular age-related macular degeneration and pathological myopia.

• CNV occurs in many different causes of uveitis and can appear as an early or late complication, leading to moderate or severe vision loss.

• Diagnosis is based on the use of multimodal imaging to distinguish between CNV and other retinal pathologies like inflammatory lesions.

• Treatment is based on anti the use of -VEGF agents together with immunosuppression to prevent vision loss and relapses.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This manuscript was not funded.