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L. Sobrin, I. K. Kim; Intravitreal Bevacizumab as Primary Treatment for Subfoveal Choroidal Neovascularization Secondary to Posterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4737.
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To report the efficacy and safety of intravitreal bevacizumab (Avastin) as the primary treatment for subfoveal choroidal neovascularization (CNV) due to posterior uveitis.
Intravitreal bevacizumab (1.25 mg/0.05 ml) was injected into three eyes of three patients with previously untreated CNV secondary to posterior uveitis in this consecutive, interventional, non-comparative case series. Snellen best-corrected visual acuity (BCVA), level of intraocular inflammation, central macular thickness on optical coherence tomography, fluorescein angiographic characteristics, and complications were examined before and after treatment. The minimum follow-up time was five months.
The underlying diagnoses were punctate inner choroiditis (PIC) in two patients and multifocal choroiditis (MFC) in one patient. Mean follow-up was 12 months (range, 5 - 18 months). All patients had quiescent inflammatory disease at the time of injection and throughout the follow-up period. No patients were on immunomodulatory therapy for their underlying diagnoses. Two eyes received a single intravitreal bevacizumab injection and one eye received three injections. BCVA improved by two or more Snellen acuity lines in the two PIC patients (from 20/125 to 20/25 in one patient and from 20/125 to 20/60 in the second patient). BCVA worsened by one line in the patient with MFC (from 20/200 to 20/320). Central macular thickness improved in all patients from a pre-injection mean of 413 microns (range, 402 - 425 microns) to a post-injection mean of 258 microns (range, 203 - 324 microns). Leakage from the CNV decreased in all eyes. No injection complications were observed.
: In this small series of eyes with limited follow-up, intravitreal bevacizumab seems to be potentially efficacious and safe in eyes with subfoveal CNV secondary to posterior uveitis. Further evaluation in larger series with longer follow-up is needed to assess the long-term efficacy and safety in such cases.
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