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V. Sivagnanavel, G. Banerjee, P. Addison, V. Papastefanou, A. Tufail, P. Hykin; The Management of Choroidal Neovascularisation Associated With Angioid Streaks With Intravitreal Bevacizumab. Invest. Ophthalmol. Vis. Sci. 2010;51(13):2226.
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To evaluate the efficacy of intravitreal Bevacizumab (Avastin) as treatment for choroidal neovascularisation (CNV) associated with angioid streaks.
A non-randomised, retrospective interventional case seriesconducted on eyes with angiographically proven subfoveal or juxtafoveal CNV associated with angioid streaks. Eleven eyes of 9 patients were treated with intravitreal Bevacizumab (1.25 mg/ 50µl). Treatment efficacy was assessed based on pre- and post-treatment LogMar visual acuity, optical coherence tomography (OCT) and fluorescein angiography. The two criteria used for considering a CNV inactive were the absence of subretinal haemorrhage or hard exudation on clinical examination and in addition, resolution or stabilisation of subretinal or intraretinal fluid on OCT imaging.
The mean follow up period was 13.27 months (range 2-36) over which a median number of 4 injections were required per treated eye. The mean pre- and post treatment LogMar visual acuity were 0.4 and 0.3 respectively. Visual acuity improved by 2 or more lines in 5 eyes (46%), remained stable within 1 line of pre-treatment vision in 4 eyes (36%) and decreased by 2 lines in 2 eyes (18%). The median period for recurrence of CNV activity was 4 months (range 2-11). No serious adverse events occurred.
Rapid visual loss, characteristic of the natural history of CNV complicating angioid streaks, can be prevented in the majority of patients for the first year after onset with repeated intravitreal Bevacizumab therapy. Longer follow up studies are required to determine the long term efficacy of this treatment.
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