Abstract
Purpose: :
Evaluate the efficacy of intravitreal Bevacizumab, an anti–vascular endothelial growth factor (VEGF) monoclonal antibody, in the treatment of choroidal neovascularization that develop in patients with angioid streaks.
Methods: :
Retrospective chart review of four patients treated with 1.25 mg of intravitreal Bevacizumab for choroidal neovascularization (CNV) secondary to angioid streaks. The diagnosis of CNV was confirmed by fluorescein angiography. Outcome measures included visual acuity, retinal thickness and retina surface contour maps based on SLO–OCT, and degree of leakage on fluorescein angiography.
Results: :
Patient #1 is a 28 year–old man with angioid streaks who extensive subretinal fibrosis and cont–fingers vision in his left eye despite treatment with photodynamic therapy for CNV who now presented with 20/50 vision, metamorphopsia and a new CNV in his right eye. At one week post–injection with intravitreal Bevacizumab his vision improved to 20/25 but started regressing at 6 weeks to 20/40 and was re–treated at 8 weeks. SLO–OCT imaging demonstrated an initial decrease in retinal thickness and a more regular retinal surface contour map with regression starting at 6 weeks. Patient #2 is an 80 year–old man with angioid streaks who presented with decreased vision in his left eye and fluorescein angiography consistent with a new CNV. Post–injection, the SLO–OCT imaging demonstrated decreased retinal thickness with an improved retinal surface contour despite a further one line decrease in his vision. Patient #3 is a 52 year–old woman with pseudoxanthoma elasticum and extensive geographic atrophy who developed new choroidal neovascularization correlated on fluorescein angiogram. The patient had a pre–injection visual acuity of 20/200. Post–injection, the fluorescein angiography demonstrated markedly decreased hyperfluorescence with stable visual acuity. Patient #4 is a 54 year–old man also diagnosed with pseudoxanthoma elasticum who presented with new occult choroidal neovascularization and 20/150 vision and was subsequently treated with intravitreal Bevacizumab.
Conclusions: :
In our cohort of patients with angioid streaks and choroidal neovascular membranes intravitreal Bevacizumab appears to improve visual acuity in some patients with corresponding improvement on SLO–OCT imaging and fluorescein angiography.
Keywords: choroid: neovascularization • clinical (human) or epidemiologic studies: outcomes/complications • injection