Role of Intravitreal Bevacizumab (Avastin) in the Management of Peripapillary Choroidal Neovascular Membrane

Abstract

 

Purpose:

 

To assess the effects of intravitreal bevacizumab as a primary treatment for peripapillary choroidal neovascularization (CNV) threatening the fovea.

 

Methods:

 

Data for three consecutive patients with sight threatening peripapillary CNV that were treated with intravitreal bevacizumab (1.25mg) injection were reviewed retrospectively. Main outcome measures included best-corrected visual acuity (BCVA), central macular thickness (CMT) measured by optical coherence tomography (OCT) and complete resolution of CNV at 12,24 and 52 weeks.

 

Results:

 

Over a mean follow-up period of 10 months(range, 6-12 months), 2 eyes received 2 injections and 1 eye required 3 injections at 6-weekly intervals to ensure complete resolution of the CNV. The CNV resolved completely in all the affected eyes (100%). The BCVA improved in 1 eye from logmar 0.8 to 0.2 and remained stable in the other 2 eyes, log mar 1.0 pre and post treatment. The CMT(graph1) decreased significantly (p<0.001) after the treatment. No adverse events occured.

 

Conclusions:

 

Intravitreal bevacizumab injection was found to be a safe and effective treatment option for peripapillary CNV in this case series with a one-year follow-up. It is difficult to conduct randomized clinical trials for this condition, but this case-series suggests the need for further case-series with larger sample size to assess the benefits of bevacizumab in this condition.  

 

Keywords: choroid: neovascularization • aging: visual performance • vascular endothelial growth factor