Purpose:
To evaluate the efficacy and safety of intravitreal bevacizumab (IVB) for the treatment of choroidal neovascularization (CNV) secondary to causes other than age-related macular degeneration (AMD).
Methods:
A retrospective review of patients affected by CNV due to causes other than AMD and treated with IVB (1 mg) was conducted. Indication for treatment was an angiographically active lesion with intra- or sub-retinal fluid accumulation on spectral domain optical coherence tomography (OCT). Patients received an injection at baseline and were then followed-up monthly. Retreatement was performed at investigator discretion based on visual acuity, OCT findings and angiographic appearance. The primary efficacy outcome was change in best corrected visual acuity (BCVA, logMAR). The incidence of ocular and non-ocular adverse events was recorded. Statistical analysis included repeated measures ANOVAs and post hoc tests with Bonferroni correction.
Results:
The study included 82 eyes of 78 patients with CNV due to pathologic myopia (PM), angioid streaks (AS), central serous chorioretinopathy (CSC), idiopathic disease (ID), choroidal nevus (CN), pattern dystrophies (PD), multifocal choroiditis (MC), punctate inner choroidopathy (PIC), laser photocoagulation (LP). Sample size, mean follow-up, mean number of injections and visual outcomes are detailed in Table 1. CNVs were located subfoveally in all eyes, except for 3 cases in the CN group and 1 case in the LP group. Ten cases (12%) experienced a moderate visual loss. This condition was observed in 5 cases among patients with PM (10%), in 4 cases in the AS group (36%) and in 1 case among CSC eyes (14%). The safety profile identified one ocular adverse reaction with the development of a post-injection episcleritis.
Conclusions:
The majority of patients included in this study had a stable or improved visual acuity at the end of the follow-up. However, there was a variability in the response to intravitreal VEGF inhibition depending on underlying etiologies. While a similar functional profile was seen during the first 6 months of follow-up, long-term outcomes were found to be worse in patients affected by AS. Better results were observed in PM, PD and ID patients.
Keywords: choroid: neovascularization • vascular endothelial growth factor