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E. Feldman, S. Lalin, R. Gentile, P. Garcia, R. Rosen; Treatment of Idiopathic Polypoidal Choroidal Vasculopathy (IPCV) with Intravitreal Bevacizumab (Avastin) Appears To Decrease Retinal Thickness and Retinal Surface Contour Based on SLO–OCT Imaging . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5183.
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To assess the efficacy of intravitreal Bevacizumab, an anti–vascular endothelial growth factor (VEGF) monoclonal antibody, in the treatment of patients with Idiopathic Polypoidal Choroidal Vasculopathy (IPCV).
Retrospective review of 4 patients with IPCV treated with 1.25mg intravitreal injection of Bevacizumab. The diagnosis of IPCV was confirmed by both fluorescein and indocyanine angiography. The outcome measures included pre and post–injection visual acuity (Va) as well as SLO–OCT imaging of the retinal thickness and retinal surface contour maps.
Patient #1 is a 54 year–old woman who presented with decreased visual acuity OU (Va 20/80 OD and 20/200 OS). Post–injection, the vision improved from 20/80 to 20/60 in the right eye with decreased retinal thickness and a more regular retinal surface contour on SLO–OCT imaging. The patient's left eye received a total of 3 injections over 8 weeks. Despite the SLO–OCT retinal thickness and retinal surface contour maps demonstrating improvement in the immediate post–injection phase, the patient's left eye experienced multiple recurrences with vision worsening to count–fingers as lipid deposits collected in the sub–foveal region. Patient #2 is a 72 year–old man with IPCV OD treated with intravitreal Bevacizumab for recurrent disease, which had previously responded poorly to photodynamic therapy and intravitreal Kenalog. Post injection the retinal thickness decreased 12.2% with an improved retinal surface contour and stable vision. Patient #3 is a 70 year–old woman who presented with decreased vision OD (Va 20/400). Post–injection the retinal thickness decreased 65.8% and in addition the retina developed a more regular anatomic contour with a formed foveal depression. The visual acuity remained stable. Patient #4 is a 65 year–old man with IPCV OD treated with intravitreal Bevacizumab after presenting with decreased visual acuity to 20/100. Post–injection the retinal thickness decreased 22.6% with improved retinal surface contour maps on SLO–OCT imaging and stable vision.
The treatment of Idiopathic Polypoidal Choroidal Vasculopathy with intravitreal Bevacizumab appears to decrease retinal thickness and improve retinal surface contour maps based SLO–OCT imaging. In this small cohort of patients with IPCV, treatment with Bevacizumab demonstrates measurable anatomic improvement without further deterioration of the vision.
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