Intravitreal bevacizumab (avastin) for choroidal neovascularization secondary to central serous chorioretinopathy, secondary to punctate inner choroidopathy, or of idiopathic origin

Am J Ophthalmol. 2007 Jun;143(6):977-983. doi: 10.1016/j.ajo.2007.02.039. Epub 2007 Apr 24.

Abstract

Purpose: To evaluate the safety and efficacy of intravitreal bevacizumab in the treatment of idiopathic choroidal neovascularization (CNV) and CNV secondary to central serous chorioretinopathy (CSC) or punctate inner choroidopathy (PIC).

Design: Prospective, nonrandomized, interventional case series.

Methods: In an institutional clinical practice, 15 patients were recruited; nine had idiopathic CNV, two had CNV secondary to CSC, and four had CNV attributable to PIC. Patients received three monthly 1.25-mg intravitreal bevacizumab injections for three months. Patients were followed for six months, and the best-corrected visual acuity (BCVA), fluorescein angiography (FA) findings, and optical coherence tomography (OCT) central foveal thickness (CFT) were assessed.

Results: At baseline, the mean logMAR BCVA was 0.48 (Snellen equivalent = 20/60). The mean logMAR BCVA improved significantly to 0.25 (Snellen equivalent = 20/36) and 0.17 (Snellen equivalent = 20/30) at one and six months, respectively (both P = .001). The mean OCT CFT reduced from 306 microm at baseline to 201 microm at six months (P < .001). All eyes (100%) had visual improvement of 1 line or more at six months, and 11 (73.3%) improved by 2 or more lines. FA showed absence of CNV leakage, the angiographic end point, at three months, and no recurrence was observed at six months in all eyes. No systemic or ocular adverse events were encountered.

Conclusions: Intravitreal bevacizumab injections resulted in visual and anatomic improvements in eyes with idiopathic CNV and CNV attributable to CSC or PIC. Further studies are warranted to assess the long-term safety and the regimen for optimal efficacy of intravitreal bevacizumab.

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Choroid Diseases / complications
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Female
  • Fluorescein Angiography
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Pigment Epithelium of Eye / pathology
  • Prospective Studies
  • Retinal Diseases / complications*
  • Serum
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity
  • Vitreous Body

Substances

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