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M. Bradbury, G. Velez; Intravitreal Avastin vs. Laser Photocoagulation for the Treatment of Peripapillary Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1460.
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To evaluate the efficacy of and explore potential indications for the use of intravitreal Avastin in the treatment of peripapillary choroidal neovascularization (PPCNV) when compared with laser photocoagulation.
The records of patients who received treatment for PPCNV were retrospectively reviewed. We assessed age, diagnosis, lesion area, location and distance to fovea, follow-up time, and response to treatment by flruorescein angiography and visual acuity.
Seven patients (8 eyes) with idiopathic PPCNV received treatment. Five eyes were treated with laser photocoagulation. Three eyes were treated with serial intravitreal Avastin injections at 2 month intervals. Of these, two had failed prior treatments (1 laser photocoagulation, 1 intravitreal Macugen). Average patient age was 74. Visual acuity at the time of presentation ranged from 20/20 to CF. Lesions were all located at the papillomacular bundle, 500 to 1500 µm from the foveal center. Lesions size ranged from 0.75-3 disc areas. Median follow-up time was 15 months (range 5-51). Regression of the lesions was confirmed by fluorescein angiography in all eyes. Visual acuity was preserved (loss < 3 lines) in 4/5 eyes treated with photocoagulation, and 3/3 eyes treated with intravitreal Avastin (average 3 injections per eye).
Both laser photocoagulation and intravitreal Avastin can be effective in the treatment of peripapillary choroidal neovscularization. Intravitreal Avastin is an effective alternative that should be considered in patients with lesions that are large, recurrent and/or encroaching on the fovea.
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