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A. F. Bordon, G. Z. Ramos, V. C. C. Afonso, L. T. Dalfre, R. B. Dichtchekenian; Bevacizumab Every 6 Weeks in the Treatment of Choroidal Neovascularization Due to Angioid Streaks. Invest. Ophthalmol. Vis. Sci. 2008;49(13):282.
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To evaluate the changes in visual acuity and recurrence rate of choroidal neovascularization (CNV) due to angioid streaks (AS) with the use of 2.5 mg of intravitreous bevacizumab every 6 weeks.
Retrospective, interventional case series study. Inclusion criterion: patients with CNV due to AS. Exclusion criteria: CNV of any other etiology, known allergy to bevacizumab or fluorescein sodium, intraocular surgery in the past 6 months, intraocular or periocular steroid injection in the past 6 months, and history of thromboembolic event in the past 6 months. Patients had a complete ophthalmological examination, fluorescein angiograms (FA) and ocular coherence tomography (OCT) performed at baseline and at each follow-up visits. Patients were submitted to three 2.5mg IVB injections, 6 weeks apart from each other, and then evaluated after 6 weeks from the third injection. Additional IVB injections were performed if a CNV recurrence was detected at the FA.
Three eyes of 3 patients with CNV were included. Three were female and left eyes; two were Caucasian and one was Japanese. Mean age was 50.7 years old (38 - 67 yrs-old). Mean visual acuity (VA) at baseline was 0.53 logMAR units (0.5 - 0.6). Mean follow-up was 6.7 months (6 - 8). After the first 3 injections, CNV recurrence occurred in two patients (one after 45 days and the other after 4 months). At baseline, the mean OCT macular thickness was 276.7µ (199 - 330µ). At the time of the CNV recurrence, the OCT macular thickness was 289µ and 266µ in those two patients. No patient lost VA during the follow-up. No ocular or systemic adverse effects were registered during the follow-up period.
2.5 mg IVB given every 6 weeks for CNV due to angioid streaks prevented further VA loss. However recurrence of the CNV occurs and additional treatment was necessary to maintain VA. Also, OCT macular thickness decreased with treatment. Further studies are needed to determine the number of injections needed to prevent VA deterioration in such patients.
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