Abstract
Purpose: :
Choroidal neovascularization (CNV) is an uncommon complication of posterior uveitis. Intravitreal bevacizumab has been successfully used for treating CNV associated with age-related macular degeneration but very few reports have described its use in the treatment of CNV secondary to uveitis. We report 5 cases of uveitic CNV that were treated with intravitreal bevacizumab.
Methods: :
We identified 6 eyes of 5 patients with uveitis that were treated with 2.5mg/0.1ml of intravitreal bevacizumab for uveitic CNV. The data collected included the demographic characteristics, ocular diagnosis, pre and post treatment visual acuity and fluorescein angiograms. The data also included the number intravitreal bevacizumab injections, follow-up time, previous treatments for uveitic CNV and status of intraocular inflammation. Main outcome measures were the changes in best corrected visual acuity (BCVA) from baseline to last follow-up and reduction in the size of the CNV.
Results: :
The various ocular diagnoses were Idiopathic Posterior uveitis, Birdshot Chorioretinopathy, Sympathetic Ophthalmia, Vogt-Koyanagi-Harada syndrome and Multifocal Choroiditis and Panuveitis. The mean patient age was 41.8 years (range 22 to 51 years). The mean follow-up time was 15.3 months (range 6 to 24 months). Previous therapies included photodynamic therapy, intravitreal triamcinolone acetonide (IVTA) and intravitreal pegaptanib injections, respectively, in 3 patients. All patients had control of ocular inflammation with systemic immunomodulatory therapy prior to receiving the intravitreal bevacizumab. The mean intravitreal bevacizumab injections administered were 2.7 (range 1-5). One patient received a combination of IVTA and bevacizumab. All patients showed a reduction in the size of the CNV at the end of treatment as evidenced on ocular exam and fluorescein angiograms. Three eyes had an improvement in the BCVA of at least 2 lines, 2 eyes had a one line decrease and one eye had a 2 line decrease in the BCVA.
Keywords: choroid: neovascularization • uvea • inflammation