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N. Gupta, J. W. Kitchens, T. W. Stone; Intravitreal Bevacizumab for the Treatment of Peripapillary Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1447.
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The purpose of this study is to evaluate the effects of intravitreal bevacizumab on peripapillary choroidal neovascularization (PPCNV) due to histoplasmosis and age-related macular degeneration.
We conducted a retrospective study investigating nine eyes of nine patients with PPCNV that were treated with intravitreal bevacizumab. All eyes underwent initial fluorescein angiography (FA) or optical coherence tomography (OCT) prior to treatment. Each eye received an intravitreal injection of bevacizumab 1.25mg (0.05 ml). Patients received a complete ophthalmic examination including retinal imaging at one month post-injection and were re-injected on a monthly basis until leakage resolved. Patients were followed for a minimum of 4 months. Post-injection visual acuity was compared to vision at presentation. Visual acuity was recorded with the snellen chart and then converted to LogMar for analysis of statistical significance.
The average patient age was 44 years (range 18 to 68) and 5 of 9 were female. Seven eyes were affected by histoplasmosis and 2 eyes were affected by ARMD. Three received only one injection, while three eyes received two injections, and three eyes received three treatments. Average initial visual acuity was approximately 20/100 (LogMar 0.684) and following one, two, or three intravitreal injections was on average 20/30 (LogMar 0.231), an improvement that was found to be statistically significant (p=0.0018). Additionally, all nine eyes had resolution of leakage on FA and normalization of foveal contour on OCT. After four months, all nine eyes were without evidence of recurrence.
The results of this study demonstrate that intravitreal bevacizumab may be an effective treatment for patients with PPCNV. Post-treatment vision was significantly improved following the use of intravitreal bevacizumab, and the treatment was well tolerated. Furthermore, all nine eyes demonstrated resolution of leakage following treatment and were without recurrence. These results suggest the need for further randomized clinical trials evaluating the role of intravitreal bevacizumab for the treatment of peripapillary choroidal neovasculaization.
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