Bevacizumab Suppresses Choroidal Neovascularization Secondary to Pathologic Myopia: A Pilot Study

Abstract

Abstract: : Purpose: The purpose of this study was to assess the effect of intravenous bevacizumab in patients with choroidal neovascularization (CNV) secondary to pathologic myopia who have failed to respond to standard therapy. Methods: Two patients with myopic degeneration and persistent CNV despite multiple treatments with photodynamic therapy were given 5 mg/kg of bevacizumab by intravenous infusion every 2 weeks for 4 infusions. Prior to starting treatment and at several intervals after treatment, patients had measurement of best–corrected visual acuity (VA) by ETDRS protocol, assessment of leakage by fluorescein angiography (FA), and measurement of retinal thickness by optical coherence tomography (OCT). Results: Prior to infusion, patients had reduced vision, subretinal fluid, macular thickening, and fluorescein leakage from active CNV. After bevacizumab infusions, both patients showed resolution of dye leakage from CNV and reduced hyperfluorescence suggesting reduced perfusion. OCTs showed resolution of subretinal fluid and reduction in retinal thickening. There was improvement in VA in 2 of 3 eyes in which there was subfoveal CNV. Both patients tolerated the infusions well with no evidence of ocular or systemic side effects. Conclusions: The rapid reduction in CNV leakage, subretinal fluid, and retinal thickening after intravenous infusion of bevacizumab suggests that VEGF is an important stimulator of CNV secondary to pathologic myopia. Controlled clinical trials are needed to determine if bevacizumab provides a safe and effective treatment in patients with pathologic myopia and CNV.

Keywords: choroid: neovascularization • myopia • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled