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Ivan Georgiev Georgiev, Petja Ivanova Vassileva, Tatyana Hergeldzhieva, Yordanka Kirilova, Petar Sapundzhiev; Beneficial effect of anti-VEGF treatment in various rare retinal diseases. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):1499.
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Intravitreal application of medications allows for more effective, targeted delivery of the drug substances into the posterior pole. Anti-VEGF therapy is suitable for a wide scope of retinal disorders, especially those associated with increased VEGF release. Our purpose is to investigate the efficacy of intravitreal anti-VEGF medications outside the approved indications (AMD, RVO and DME), and to confirm that it is a beneficial treatment option for choroidal neovascularization (CNV) in various rare retinal diseases.
Retrospective review of the clinical records of patients with active CNV, divided into four groups according to the diagnosis was performed: group 1 - patients with pathological myopia (PM), group 2 -central serous chorioretinopathy (CSC), group 3 -dominant drusen (DD) and group 4 -pseudoxanthoma elasticum(PXE). All patients recieved three intravitreal Bevacizumab (1.25 mg) and/or Aflibercept (2 mg) at monthly intervals. Further treatment was administered, depending on disease activity. Baseline and monthly follow up visits included BCVA and full eye exam with retinal imaging.
Twenty four patients (30 eyes) were included in the review. Group 1 (PM) consisted of 5 male and 11 female (20 eyes) with mean age-64 years and mean baseline BCVA-0.35. After treatment we registered most significant improvement with increase of mean BCVA to 0.7. In group 2 (CSC) 3 male and 1 female (4 eyes) were included, with mean age-44 years and mean baseline BCVA-0.8. After treatment all patients reached visual acuity of 1.0. All four patients from group 3 (DD) and group 4 (PXE) also improved visual acuity. Macular condition stabilized and central macular thickness decreased in all groups as a result of the treatment.<br />
Our study confirms the hypothesis that intravitreal anti-VEGF therapy is effective both functionally and morphologically in patients with CNV secondary to varied retinal pathology such as PM, CSC, DD and PXE. This encourages us to conduct further research on anti-VEGF treatment in patients with varied retinal pathology, associated with neovascularization.
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