Abstract
Purpose: :
To describe the clinical outcome of five patients receiving an intravitreal (I–V) injection of the monoclonal antibody Bevacizumab as treatment of Choroidal Neovascularization (CNV) associated with Angiod Streaks.
Methods: :
A prospective clinical interventional study of 3 patients not previously treated and 2 non responders to Photodinamic Therapy with choroidal neovascularization and angioid streaks. One of the non treated patients had bilateral CNV and both eyes were included. The patients received a single I–V injection of 1.25mg (0.1 cc) bevacizumab. Follow–up included clinical examination (best corrected LogMAR visual acuity, intraocular pressure (IOP), cataract grading, activity signs of CNV and systemic check–up) at 1 day, 1,2,4 and 6 weeks. OCT and fluorescein angiogram were evaluated at 6 weeks.
Results: :
All of patients were successfully followed–up by one month of the study (a total of 6 eyes), 3 months follow–up is still in course. There were no vision or life threatening adverse events. No significant IOP increases neither lens opacities were recorded. Four lesions were subfoveal and two were extrafoveal. Treatment with bevacizumab resulted in a 83.33% reduction of subretinal fluid accumulation with complete resolution of SRF in 66.6% of cases. There was also an 83.3% reduction of neovascularization site thickness. Correlation with the pre–treatment and post–treatment angiographic patterns resulted in 83.3% of reduction in leakage and 66.6% of resolution of leakage at all. A total of 4 eyes showed complete resolution, one eye had reduction of thickness and SRF, with improve of angiographic pattern but no improvement of visual acuity and one patient showed no reduction of SRF and angiogram leakage and VA remain the same, this patient was PDT non responder.
Conclusions: :
The data support the use of a single injection of Bevacizumab in the treatment of choroidal neovascularization associated with angioid streaks even though a comparative randomized study is needed.
Keywords: choroid: neovascularization • pharmacology • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials