Intravitreal bevacizumab for refractory choroidal neovascularization (CNV) secondary to uveitis

Graefes Arch Clin Exp Ophthalmol. 2008 Dec;246(12):1685-92. doi: 10.1007/s00417-008-0906-4. Epub 2008 Aug 6.

Abstract

Purpose: To assess the short-term efficacy and safety of intravitreal bevacizumab injections (IVB) for refractory choroidal neovascularization (CNV) secondary to uveitis.

Methods: Ten patients affected by choroidal neovascularization secondary to uveitis unresponsive to immunosuppression associated or not with photodynamic therapy (PDT) were consecutively included. All patients underwent a complete ophthalmic examination including best-corrected visual acuity (BCVA), fluorescein (FA) and indocyanine green angiographies (ICG), optical coherence tomography (OCT) at baseline, and after IVB injection (1.25 mg/0.05 ml).

Results: CNV was subfoveal in eight cases and juxtafoveal in two cases. Mean follow-up was 7.5 months. After treatment, the logMAR BCVA improved from 0.62 +/- 0.4 (Snellen equivalent of 20/55) to 0.45 +/- 0.35 (Snellen equivalent of 20/40) at 1 month (p = 0.01), then remained stable during the follow-up. Mean central macular thickness (CMT) was reduced from 326 +/- 95 microm before treatment to 267 +/- 28 microm (p = 0.03) at last visit. Mean number of IVB was 2.5. Leakage from inflammatory CNV was stopped in three eyes and decreased in seven eyes. No systemic or ocular adverse events were recorded.

Conclusions: Intravitreal bevacizumab improves BCVA and reduces central macular thickness in eyes with inflammatory CNV refractory to immunosuppression associated or not with PDT. Further study is necessary to assess the efficacy and safety in the long term.

MeSH terms

  • Adult
  • Aged
  • Angiogenesis Inhibitors / administration & dosage*
  • Angiogenesis Inhibitors / adverse effects
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Choroidal Neovascularization / complications
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology*
  • Choroidal Neovascularization / physiopathology
  • Diabetic Retinopathy / complications
  • Drug Administration Schedule
  • Female
  • Fluorescein Angiography
  • Humans
  • Injections
  • Macula Lutea / pathology
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome
  • Uveitis / complications*
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / drug effects
  • Vitreous Body*
  • Vitreous Hemorrhage / etiology
  • Young Adult

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab