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Anthony B. Daniels, Corey B. Westerfeld, Akira Hagiwara, Christopher M. Andreoli, Shizuo Mukai; Intravitreal Bevacizumab for Idiopathic Macular Choroidal Neovascular Membrane in Pediatric Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4514.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of intravitreal injection of bevacizumab (Avastin®) in idiopathic macular choroidal neovascular membranes (CNVM) in pediatric patients.
Retrospective chart review of consecutive patients with idiopathic macular CNVM, 18 years of age or younger, who presented to the Retina Service of the Massachusetts Eye and Ear Infirmary and were treated with an intravitreal injection of bevacizumab. CNVM from inflammatory or traumatic causes were excluded, as were patients with retinal dystrophies or positive infectious serologies.
Seven pediatric patients, aged 18 months to 18 years, with idiopathic macular CNVM were identified. Of these, 3 patients (ages 18 months, 16 years, and 18 years) were treated with intravitreal injections of bevacizumab (dose: 1.25 mg for the 16 year old and the 18 year old and 0.625 mg for the 18 month old). CNVM was either subfoveal or perifoveal with the neurosensory detachment (NSD) extending into the fovea as determined by optical coherence tomography, fluorescein angiography, or both. The CNVM was unilateral and unifocal in each case. There was regression of CNVM and resorption of the NSD in each case. Visual acuity improved from counting fingers to 20/80+2 in the 16 year old (at 7 months) and from 20/500 to 20/32 in the 18 year old (at 10 months). Acuity could not be reliably determined pre- or post-injection in the infant. Mean number of injections was 2 (range 1-3). There is no case of recurrent or new CNVM in the period of follow up that ranged from 5 to 10 months. There were no ocular or systemic complications.
Intravitreal injection of bevacizumab is effective in treatment for subfoveal and perifoveal idiopathic macular CNVMs in the pediatric population. It appears to be safe in this age group, even in patients as young as 18 months of age.
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