Purchase this article with an account.
S. Iyengar, D. S. Dyer, G. M. Fox, B. A. Cooper; New VEGF Inhibitors in the Treatment of CNV From POHS. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1432.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To investigate the visual outcomes and angiographic responses from intravitreal injection of bevacizumab and ranibizumab for choroidal neovascularization from presumed ocular histoplasmosis syndrome.
Fourteen eyes with choroidal neovascularization due to ocular histoplasmosis were treated with serial intravitreal injections of bevacizumab or ranibizumab. Eleven of the fourteen eyes were treated with bevacizumab. Four of those eleven had de novo lesions treated only with bevacizumab. Three eyes were treated with ranibizumab. Each of the 3 eyes treated with ranibizumab had prior submacular surgery or photodynamic therapy. All angiographic lesion sizes were measured by the same surgeon, prior to starting, and subsequent to cessation of intravitreal injection.
Of the 11 eyes treated with bevacizumab, 72% (8 eyes) had visual stability or improvement in vision. Those that reached the endpoint of no leakage seen on the angiogram required an average of 3.33 injections. New lesions with primary bevacizumab therapy seemed to require fewer injections. One patient had been treated with ocular photodynamic therapy and 8 prior injections of pegaptanib before visual gain and angiographic stability were achieved with ranibizumab. Another patient who responded well to bevacizumab therapy, developed a new neovascular membrane in the contralateral eye and has since begun treatment. Of the three patients treated with ranibizumab, no leakage was achieved in one patient with a subfoveal lesion after two injections. The remaining two patients have received two and three injections, respectively, and are continuing treatment.
Bevacizumab and ranibizumab treatment of CNV from POHS shows visual stability and favorable angiographic changes that may be similar to their effects in the treatment of choroidal neovascularization in ARMD. Lesions may show selective responses to the type of VEGF inhibitor and may respond to intravitreal injection when prior treatment with vertefporfin therapy has failed. Bevacizumab may show greater success rates when treating new lesions that have not had prior submacular surgery or ocular photodynamic therapy.
This PDF is available to Subscribers Only