gms | German Medical Science

25th Annual Meeting of the German Retina Society

German Retina Society

01.06. - 02.06.2012, Münster

Treatment of choroidal neovascularization due to angioid streaks – a metaanalysis

Meeting Abstract

  • Martin Gliem - Universitäts-Augenklinik Bonn
  • R.P. Finger - Universitäts-Augenklinik Bonn
  • C.K. Brinkmann - Universitäts-Augenklinik Bonn
  • F.G. Holz - Universitäts-Augenklinik Bonn
  • P. Charbel Issa - Universitäts-Augenklinik Bonn

German Retina Society. 25th Annual Conference of the German Retina Society. Münster, 01.-02.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12rg13

DOI: 10.3205/12rg13, URN: urn:nbn:de:0183-12rg131

This is the translated version of the article.
The original version can be found at: http://www.egms.de/de/meetings/rg2012/12rg13.shtml

Published: May 30, 2012

© 2012 Gliem et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Purpose: Angioid streaks represent an uncommon condition which predispose for choroidal neovascularizations (CNV). Possible treatment options include VEGF-inhibitors, PDT, laser photocoagulation or CNV extraction. As this is a rare entity randomized controlled trials for therapeutic interventions have not been performed and recommendations are based on case series. In this metaanalysis all published studies were analysed to allow for a better judgement on the efficacy of current therapeutic measures.

Methods: A systematic literature search was performed during February/ March 2012 using the Pubmed database. (Terms of search: angioid streaks, bevacizumab, ranibizumab, photodynamic therapy, laser photocoagulation, CNV extraction, natural history). Cited relevant literature of identified articles was also included. Primary outcome measure was change of best corrected visual acuity (BCVA).

Results: We identified 47 published studies. Treatment with VEGF inhibitors on average was found to improve or at least to stabilize BCVA in all case series. PDT resulted in a slowing of the disease progression and improvement of BCVA was only noted in few cases. Laser photocoagulation yielded comparable results to PDT but application was mostly restricted to extrafoveolar lesions and comlicated by frequent recurrences. Combination treatments showed similar results to monotherapies.

Conclusions: The results indicate that intravitreal VEGF inhibitors are currently the most efficacious treatment for CNV due to angioid streaks. PDT is obviously inferior as is laser photocoagulation, whereby the latter is also destructive with subsequent absolute scotoma. Combination treatments appear to have no advantage compared to monotherapy.