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C. Rosina, A. Invernizzi, F. Bottoni, G. Staurenghi; Macular Atrophic Changes in Patients Treated With Bevacizumab for Myopic Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2193.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the macular atrophic changes in patients with choroidal neovascularization (CNV) secondary to pathological myopia, treated with intravitreal (IVT) injections of bevacizumab.
Consecutive patients treated with IVT injections of bevacizumab (1.25 mg) for subfoveal choroidal neovascularization due to pathological myopia between February 2006 and October 2009, were studied retrospectively. We compared infrared (IR), redfree (RF), autofluorescence (AF) images and fluorescein angiograms performed before and after treatments (Heidelberg Retina Angiograph HRA or HRA2). Atrophic areas were calculated with the software of the instrument.
Fifteen eyes of 15 patients were included. The mean age was 47.53 years (range 28-65). Myopia ranged from -8 to -15.diopters (mean -11.07). Initial mean VA was 0.28. After a long-term follow-up of 38.26 months (mean, range 27-42) and a mean of 2.66 bevacizumab injections, mean VA was 0.4 and all eyes revealed obliteration of the CNV. In 2 eyes (13.33%) the macula didn’t show either a scar or a chorioretinal atrophy; 4 eyes (26.67%) developed fibrosis and 9 (60%) eyes suffered from occurence or enlargement of chorioretinal atrophy (mean initial area : 3.88 mm²; mean final area: 5.22 mm²).
In this small series of patients treated with bevacizumab there was an increased chorioretinal atrophy after a mean follow up of 38.26 months in 60% of the cases. Progression of atrophy in high myopia with CNV has been already reported in eyes without any treatment (Kojima A. et al.Graefe’s Arch Clin Exp Ophthalmol (2004) 242(2):114-119) or in eyes submitted to photodynamic therapy (Hayashi K. et al. AM J Ophthalmol 2009 Sep; 148(3):396-408.). Further studies are needed to confirm a direct correlation between IVT injection of bevacizumab and progression of chorioretinal atrophy in patients with CNV due to high myopia.
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