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L. Concha, V. Kon, J. Unzueta, P. Navarro, L. Arellanes; Intravitreal Bevacizumab for the Treatment of Neovascular Membrane in Patients With Intraocular Inflammation. Invest. Ophthalmol. Vis. Sci. 2007;48(13):5144.
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To report the use of intravitreally administered anti-vascular endothelial growth factor, bevaciumab, in subretinal neovascular membrane in patients with intraoculara inflammation.
Aprospective interventional study was carried out. Bevacizumab (2.5mg/0.1ml) was administered intravitretally in five patients. Four patients with subfoveal membrane: 3 with Vogt Koyanagi Harada syndrome (VKH) in chronic stage, one with multifocal choroiditis and one patient with yuxtafoveal membrane with serpiginous choroiditis. A complete ophthalmologic examination was done, measurement of best corrected visual acuity (BVCA), optical coherence tomography (OCT), and fluorescein angiography (FA). Main outcomes measures were changes between baseline and last follow-up of BCVA and neovascular membrane activity.
We studied 5 eyes of 5 patients (four were female). Mean age 36.6 (23-56) years. Mean follow up 19.2 (9-31 weeks). Initial BCVA was counting fingers. FA showed early stainging of the neovascular membrane. Optical cohererence confirmed membrane location.BCVA improved from counting fingers to 20/40 in three VKH patients, and to 20/20 in the serpiginous choroiditis. Statistically significant changes from baseline BCVA were observed (p<.001); no improvement was found in one patient with VKH and in the patient with multifocal choroiditis one. After injection, clinical, FA and OCT manifestations of neovascular membrane disappeared. Treatment was well tolerated and no reactivation of inflammation was observed.
Subretinal neovascularization in VKH, multifocal and serpiginous choroiditis has been reported in 2.5% to 10%, 33% and 45% respectively. Intravitreal bevacizumab promoted an early recovery of BCVA in some eyes with neovascularization secondary to inflammatory disease. Even though it appears to be a safe treatment a longer follow-up needs to be done to evaluate its long term effect.
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