Abstract
Purpose: :
To evaluate the efficacy of intravitreal bevacizumab in the treatment of choroidal neovascularization (CNV), in patients with pathological myopia, unresponsive to photodynamic therapy (PDT).
Methods: :
Retrospective chart review of 20 consecutive patients treated with intravitreal (IVT) bevacizumab (1.25 mg) for subfoveal choroidal neovascularization due to pathological myopia between February 2006 and November 2008. All patients were previously treated with PDT. Recurrence of CNV was confirmed by fluorescein and indocyanine green angiography. Outcome measures included visual acuity (VA), retinal thickness with OCT, and degree of leakage on fluorescein and indocyanine green angiography.Incidence rate of CNV recurrences was calculated using the Kaplan-Meier method.
Results: :
Twenty eyes of twenty patients were included. The mean age was 55.9 years (range 33-79). The baseline mean VA was 0.26. After a mean follow up of 25.4 months (range 13-31), the mean VA was 0.3 and in 16 of 20 eyes the CNV was obliterated. Six of 20 eyes (30%) received 1 bevacizumab IVT, seven (35%) 2 injections, one (5%) 3 injections, 3 (15%) 4 injections and 3 eyes (15%) received 5 IVT. All eyes (14), receiving 1, 2 or 3 treatments, had angiographic closure of lesion, the same result was also achieved in the eyes subjected to 4 IVT (1 eye) and 5 IVT (2 eyes). In our sample 65% of lesions was closed after 2 injections and 75% of lesions remained closed after a mean of 3.8 injections (SE: 3.7).There were no systemic or ocular complications.
Conclusions: :
In this small series of CNV due to pathological myopia and unresponsive to PDT, intravitreal bevacizumab showed a good efficacy and safety. Further studies are needed to evaluate a larger number of patient and a longer follow up.
Keywords: myopia • choroid: neovascularization • vascular endothelial growth factor