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I. Yamamoto, A.H. Rogers, P. Yates, E. Reichel, J.S. Duker, C.R. Baumal; Intraocular Bevacizumab (Avastin) as Treatment for Subfoveal Choroidal Neovascularization Secondary to Pathologic Myopia . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4265.
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To evaluate the efficacy and safety of intravitreal bevacizumab (1.25mg) as either rescue therapy or primary treatment of subfoveal choroidal neovascularization (CNV) due to pathologic myopia.
All eyes with recurrent or primary subfoveal CNV secondary to myopia and treated between August 2005 and December 2005 with intravitreal bevacizumab 1.25mg were reviewed in a retrospective fashion. Fluorescein angiography, optical coherence tomography (OCT), and Snellen visual acuity were performed at baseline and all follow–up visits to evaluate the efficacy of treatment.
Seven eyes of 5 patients (all female) with a mean age of 53 years (range, 44 to 70 years) underwent intravitreal injections with bevazicumab 1.25mg in 0.05ml volume. Four of 7 eyes were previously treated with photodynamic therapy with visudyne, and 3 eyes were treated with bevacizumab alone as primary therapy. Pre–injection Snellen visual acuities (VA) measured 20/20 to 20/40 in no eyes, 20/50 to 20/100 in 5 eyes, and 20/200 or worse in 2 eyes. Mean central foveal thickness (CFT) prior to intravitreal bevacizumab was 311 um (range 253 to 380 um). After a mean follow up of 37 days (range, 21 to 63 days), post–injection VA measured 20/20 to 20/40 in 2 eyes, 20/50 to 20/100 in 5 eyes, and 20 /200 or worse in no eyes. VA improved a mean of +4.6 Snellen lines (range, +2 to +8 lines) with all eyes 20/50 or better. Mean CFT measured 226um (range, 142 to 316um), which represented an average standardized change in macular thickness of 70% (range, 7 to 156%) and an average reduction of 85um (range, 5 to 164um) from pre–injection CFT. All patients received one treatment only. No injection complications or drug–related side effects were observed.
In this small series of eyes with limited follow–up, intravitreal bevazicumab appears to be a safe in eyes with subfoveal CNV secondary to pathologic myopia when used as both primary treatment and rescue therapy. Further follow–up is necessary to confirm long term treatment benefit.
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