title: Long-term follow-up of patients with choroidal neovascularization due to angioid streaks.
abstract: BACKGROUND
  The following case series describes the long-term anatomical and functional outcome of a group of seven patients with choroidal neovascularization (CNV), secondary to angioid streaks (AS), who were treated with antiangiogenic drugs in a pro re nata (PRN) regimen. After the 4-year mark, visual acuity tends to return to pretreatment level. Treatment delays and lack of awareness and self-referral by the patients are believed to be the cause of the PRN regimen failure.
  
  
  OBJECTIVE
  To assess the long-term outcomes (>4 years) of patients with CNV due to AS treated with a PRN regimen of antiangiogenic.
  
  
  METHODS
  This was a retrospective, case series, single-center study. We reviewed the electronic medical records from patients with CNV due to AS. From each record, we noted general demographic data and relevant medical history; clinical presentation, changes in best-corrected visual acuity (BCVA) over time, optical coherent tomography parameters, treatment and retreatment details, and systemic associations. Changes in BCVA and central macular thickness were assessed with a Wilcoxon two-sample test, with an alpha value of ≤0.05 for statistical significance.
  
  
  RESULTS
  The mean follow-up time was 53.8±26.8 months. BCVA at baseline was: 1.001±0.62 logMAR; at the end of follow-up: 0.996±0.56 logMAR (P=0.9). Central macular thickness at baseline was: 360.85±173.82 μm; at the end of follow-up: 323.85±100.34 μm (P=0.6). Mean number of intravitreal angiogenic drugs: 6±4.16 injections (range 4-15). Mean time between injections was 3.8±2.7 months (range 1.9-5.8 months).
  
  
  CONCLUSIONS
  Despite initial anatomical and functional improvement, patients at the end of the follow-up had no visual improvement after a pro re nata regimen of antiangiogenic drugs. The amount of retreatments, number of recurrences, and time between intravitreal injections were similar to previous reports with shorter follow-up.
authors.affiliation: Retina Department.
authors.forename: Maria Guadalupe
authors.initials: MG
authors.lastname: Martinez-Serrano
authors.affiliation: Pathology Department, Asociación para Evitar la Ceguera en Mexico, Hospital "Dr Luis Sanchez Bulnes" IAP.
authors.forename: Abelardo
authors.initials: A
authors.lastname: Rodriguez-Reyes
authors.affiliation: Retina Department; Macula Retina Consultants, Mexico City, Mexico.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Guerrero-Naranjo
authors.affiliation: Retina Department.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Salcedo-Villanueva
authors.affiliation: Retina Department; Macula Retina Consultants, Mexico City, Mexico.
authors.forename: Jans
authors.initials: J
authors.lastname: Fromow-Guerra
authors.affiliation: Retina Department; Macula Retina Consultants, Mexico City, Mexico.
authors.forename: Gerardo
authors.initials: G
authors.lastname: García-Aguirre
authors.affiliation: Retina Department.
authors.forename: Virgilio
authors.initials: V
authors.lastname: Morales-Canton
authors.affiliation: Retina Department; Macula Retina Consultants, Mexico City, Mexico.
authors.forename: Raul
authors.initials: R
authors.lastname: Velez-Montoya
keywords: angioid streaks; antiangiogenic; bevacizumab; choroidal neovascularization; long term; outcome; ranibizumab