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M. Rinaldi, R. Dell'Omo, M. R. Romano, F. Chiosi, M. Romano, C. Costagliola; Efficacy and Safety of Intravitreal Bevacizumab for Choroidal Neovascularization Secondary to Angioid Streaks Assessed Throughout 30 Months Follow-Up. Invest. Ophthalmol. Vis. Sci. 2009;50(13):768. doi: https://doi.org/.
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To ascertain the efficacy and safety of intravitreal bevacizumab (IVB) in the treatment of choroidal neovascularization (CNV) secondary to angioid streaks (AS) assessed throughout a long term follow-up (30 months).
Patients with CNV secondary to AS were recruited in this retrospective interventional case series study. All patients were scheduled for three monthly IVB injections (1.25 mg). IVB was repeated in case of recurrence after the three monthly IVB scheduled. Ophthalmic evaluations included: best corrected visual acuity (BCVA) determination (ETDRS), optical coherence tomography (OCT), fluorescein and indocyanine green angiographies. Main outcome measures were BCVA improvement, reduction of leakage from CNV and diminution of central retinal thickness (CRT). Patients were followed for 30 months.
Patient series included six eyes of five patients (male: female; 3: 2; age: 51.6 +/- 9.07 SD ; age range: 44 - 67 years). Two eyes had been previously treated with photodynamic therapy (PDT), whereas four eyes received IVB as first choice treatment. The mean number of IVB injections was: 4.33 (+/-1.5; min: 3, max: 7). The mean retreatment interval was 3 months (+/-1.36; min: 2, max: 6). Four eyes (66.6%) showed a BCVA improvement (mean 3.4 lines) from baseline and two eyes (33.3%) did not show any change in their visual acuity from baseline at the last check. Mean BCVA increased significantly from 22.5+/-14.4 letters at baseline to 35.8+/-21.5 letters at 30 months (p=0.025). Angiographic examinations showed reduction or ending of the CNV leakage in all patients. OCT findings demonstrated slight CRT diminution (mean 41.6 µm). No significant ocular and/or systemic side effects or adverse events occurred.
Despite the small number of patients observed, the long term follow-up performed demonstrate that IVB injection represents a safe and effective option in the management of CNV secondary to AS.
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