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Simona Romano, Francesco Pichi, Andrea Lembo, Mariachiara Morara, Antonio P. Ciardella, Paolo Nucci; Treatment of Complicated Retinal Arterial Macroaneurysm with Intravitreal Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2012;53(14):2940.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the anatomical and functional results of the treatment with bevacizumab (Avastin®) in complicated retinal arterial macroaneurysm (RAM).
37 eyes with retinal complications associated with a retinal arterial macroaneurysm affecting the fovea were evaluated. All patients underwent a comprehensive ophthalmologic examination, fluorescein angiography, and OCT examination.Each patient included underwent 3 monthly injections of bevacizumab (Avastin®) 1.25 mg/0.05 ml; three follow-up visits were planned at week 2,6 and 10, and the last follow-up took place 6 months from the initial visit.
At 2 weeks following the first intravitreal bevacizumab (Avastin®) injection, mean BCVA improved to 0.32±0.02 logMAR (p = 0.0254). Most eyes with minimal hemorrhage showed resolution of the exudative changes, along with a physiologic appearance of the fovea. In eyes with a predominant hemorrhagic component, the retinal hemorrhage was reduced and mean CRT decreased by 329.6 µm to 213.9 µm. At 6 weeks of follow-up, 2 weeks after the second injection, FA showed complete closure of the macroaneurysm in 36/38 cases (94.7%) and the macular edema surrounding the macroaneurysm resolved further. Two weeks following the third injection, the macular edema had completely resolved and hard exudates regressed slowly in 100% of patients.
Anti-VEGF drugs might actively close the involved pathologically permeabilized retinal artery and normalize the vessel wall formation by localized inhibition of VEGF.This is the first case series of patients who have been treated with intravitreal bevacizumab (Avastin®) therapy for retinal macroaneurysm and showed rapid decrease in CRT and visual improvement.
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