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A. N. San Filippo, M. A. Cassell, N. R. Sabates, A. Poulose, F. N. Sabates; Effect of Bevacizumab on Fluorescein Angiography, Optical Coherence Tomography, and Visual Acuity in Patients With Choroidal Neovascular Membrane Secondary to Histoplasmosis Retinitis. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1452.
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To evaluate the effect of bevacizumab on fluorescein angiography, optical coherence tomography, and visual acuity in patients with choroidal neovascular membrane secondary to histoplasmosis retinitis.
Eight eyes of seven patients with subretinal neovascular membrane secondary to histoplasmosis underwent injection of bevacizumab as monotherapy or following unsuccessful treatment with either focal laser or photodynamic therapy with intravitreal triamcinolone. Pre-injection examination and follow-up examinations included determination of visual acuity, fluorescein angiography, and optical coherence tomography. Patients were followed for a minimum of three months following intravitreal injection.
Intravitreal injection was well-tolerated in all patients. No patients developed vitreous hemorrhage, infection, uveitis, or elevated intraocular pressure. Treatment with bevacizumab resulted in improvement in visual acuity, improved angiographic appearance, and reduction of subretinal fluid. In selected cases, primary treatment with bevacizumab was followed by successful argon laser treatment of the residual choroidal neovascular membrane.
Bevacizumab appears to be promising as short-term treatment of choroidal neovascular membrane secondary to histoplasmosis retinitis. Bevacuzimab may show efficacy in lesions refractive to initial treatment with photodynamic therapy with intravitreal triamcinolone or focal laser. Reduction of the lesion size and subretinal fluid with bevacizumab may also facilitate argon laser obliteration of the remaining lesion with less damage to adjacent retinal tissue.
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