Browsing by Author "Bhatti, M. Tariq"

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    Management of Peripapillary Choroidal Neovascular Membrane in Patients with Idiopathic Intracranial Hypertension
    (Wolters Kluwer, 2019-12) Ozgonul, Cem; Moinuddin, Omar; Munie, Metasebia; Lee, Michael S.; Bhatti, M. Tariq; Landau, Klara; Van Stavern, Gregory P.; Mackay, Devin D.; Lebas, Maud; DeLott, Lindsey B.; Cornblath, Wayne T.; Besirli, Cagri G.; Ophthalmology, School of Medicine
    Objective: To report the clinical features and treatment outcomes of patients with peripapillary choroidal neovascular membrane (CNVM) secondary to idiopathic intracranial hypertension (IIH). Methods: Retrospective, multicenter chart review of patients diagnosed with peripapillary CNVM in the course of the treatment and follow-up of IIH. Results: Records were reviewed from 7 different institutions between 2006 and 2016. Ten patients (13 eyes) with a diagnosis of IIH and at least 3 months of follow-up developed CNVM. Three of the total 10 patients developed bilateral CNVM. The mean time from the diagnosis of IIH to CNVM diagnosis was 41 months. Mean follow-up period was 8 months after diagnosis of CNVM. All patients were treated with acetazolamide for IIH. Seven eyes were observed, and 6 eyes were given anti-vascular endothelial growth factor (anti-VEGF) injections, including bevacizumab, ranibizumab, and aflibercept. All CNVMs regressed with subretinal fibrosis, and visual acuity improved in most patients. Papilledema resolved in only 1 eye, while the other 12 eyes had persistent papilledema at last follow-up. Conclusions: Peripapillary CNVM, a rare complication of IIH, often resolves spontaneously with treatment of IIH. In vision-threatening and/or persistent cases, intravitreal anti-VEGF treatment may be a safe and effective therapeutic option.
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    The 'Fault' Lies in the Choroid: Peripapillary Intrachoroidal Cavitation Presenting with Progressive Vision Loss
    (Taylor & Francis, 2022-01-25) Belamkar, Aditya V.; Dolan, Joseph; Olatunji, Sunday; Bhatti, M. Tariq; Chen, John J.; Mansukhani, Sasha A.; Ophthalmology, School of Medicine
    A 55-year-old male was referred to the Neuro-ophthalmology clinic due to gradual onset, progressive vision loss. On fundus examination a subtle yellow-orange peripapillary lesion was detected in the left eye. Optical coherence tomography with radial scanning illustrated retinal nerve fibre layer thinning as well as an area of intrachoroidal cavitation that corresponded to the lesion. Visual field testing showed a left inferior arcuate defect. Magnetic resonance imaging of the brain and orbit, and laboratory testing was unremarkable. Clinical examination, imaging, and testing were consistent with peripapillary intrachoroidal cavitation (PICC). Follow-up with serial visual field testing showed mild progression of the field defect. While PICC is not well understood in the literature, studies have reported associated risk factors including pathological myopia, older age, increased ocular axial length, chorioretinal atrophy, and vascular abnormalities. Importantly, glaucoma-like visual field defects as well as structural changes have been noticed in a high proportion of patients with PICC. While these alterations are evident, the pathogenic relationship between them is yet to be uncovered. Treatment with anti-glaucoma medications has been suggested, however, the evidence remains scarce for its true benefits. Care providers must be aware of the presentation of a yellow-orange peripapillary lesion with an associated visual field defect to accurately diagnose and manage this condition.