[Long-Term Outcome in Patients with Intravitreal Anti-VEGF Therapy for Exudative AMD]. / Langzeit-Verlauf bei Patienten mit intravitrealer Anti-VEGF Therapie für neovaskuläre AMD.

BACKGROUND: Randomized controlled phase III studies have shown that intravitreal anti-VEGF therapy is effective for exsudative age-related macular degeneration (AMD) over two years. Recently, the seven-year outcomes in ranibizumab-treated patients of the ranibizumab phase III studies have been published. Only a few other studies with such a long follow-up for intravitreal anti-VEGF therapy in patients with exsudative AMD have been published so far. We report on the outcome of patients receiving intravitreal anti-VEGF therapy for exudative AMD at the Department of Ophthalmology, University Hospital of Zurich with follow-up of 3 to 7 years. PATIENTS: Retrospective chart review of all patients treated at our institution for exudative AMD with begin of treatment since 2006. RESULTS: The numbers of patients with a follow-up of 3 to 4, 4 to 5, 5 to 6, 6 to 7, and more than 7 years were 430, 277, 151, 87, and 47, respectively. Mean follow-up time was 4.9 years, and median was 4.6 years. Changes in visual acuity for these patients were -5.0, -7.8, -11.7, -12.8, and -19.2 ETDRS letters, respectively. CONCLUSIONS: Whereas in patients with exudative AMD during the first two years of intravitreal anti-VEGF treatment visual acuity can at least be stabilised, after three and more years visual acuity decreases in spite of continued treatment.

Follicular conjunctivitis caused by a mantle cell lymphoma.

BACKGROUND: Lymphoma of the conjunctiva as part of a systemic disease is rare. The follicular appearance of the lymphocyte hyperplasia may mimic the clinical picture of infectious or allergic conjunctivitis. We report on a case of marked chronic follicular conjunctivitis, finally diagnosed as mantle cell lymphoma. HISTORY AND SIGNS: A 52-year old male with a history of epiphora for one year, presented with follicular conjunctivitis in both eyes, a nodal mass in the upper right eyelid and nuchal lymphadenopathy. No infectious or allergic aetiology could be found. Conjunctival biopsy revealed a mantle cell lymphoma. Magnetic resonance tomography showed a bilateral spread into the orbital cavity. Other sites of involvement were the epipharynx and the cervical, axillary and paratracheal lymph nodes. THERAPY AND OUTCOME: Chemotherapy with hyper-CVAD (cyclophosphamide, vincristine, doxorubicine, dexamethasone) was initiated. After 4 of 6 cycles, all clinical tumour manifestations had disappeared completely. CONCLUSIONS: Conjunctival lymphoma may clinically resemble follicular conjunctivitis. Conjunctival biopsy may lead to early diagnosis and initiation of therapy.