Abstract
Purpose: :
To assess the efficacy of intravitreal Bevacizumab, an anti–vascular endothelial growth factor (VEGF) monoclonal antibody, in the treatment of patients with myopic degeneration complicated by choroidal neovascularization.
Methods: :
Retrospective review of 3 patients with myopic degeneration treated with 1.25mg of intravitreal Bevacizumab for choroidal neovascularization. At presentation, the patients were imaged with flourescein and indocyanine angiography in addition to SLO–OCT imaging. The outcome measures were vision, retinal thickness and the retinal surface contour maps.
Results: :
Patient #1 is a 52 year–old woman who presented with decreased vision in the right eye (Va 20/400). Post–injection, the vision improved to 20/60 with the retinal thickness decreasing 18.8% and the retinal surface contour map improving 9% on SLO–OCT imaging. Patient #2 is a 48 year–old man who presented with metamorphopsia and decreased vision in the left eye (count–fingers at 1 foot). Post–injection, the retinal thickness decreased by 49.9% and retinal surface contour map decreased by 32% on SLO–OCT imaging. The patient was then treated with a second intravitreal injection of Bevacizumab as the SLO–OCT image demonstrated residual fluid. The retinal thickness decreased an additional 8% with a corresponding 18.5% improvement in the retinal surface contour map. The visual acuity, however, only improved marginally to count fingers at 3 feet despite the dramatic anatomic improvement probably due to extensive sub–retinal fibrosis. Patient #3 is a 64 year–old man who presented complaining of decreased vision in the left eye with a small sub–foveal hemorrhage. Angiography demonstrated the presence of a choroidal neovascular membrane. Two weeks post–injection, the retinal thickness had decreased 40% with a stable visual acuity.
Conclusions: :
The treatment of choroidal neovascularization in patients with myopic degeneration with intravitreal Bevacizumab appears to decrease retinal thickness and improve retinal surface contour maps based SLO–OCT imaging. In addition, patients without extensive scarring may potentially recover functional vision with anti–VEGF treatment.
Keywords: choroid: neovascularization • retinal neovascularization • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)