J Korean Ophthalmol Soc.  2009 Sep;50(9):1334-1340. 10.3341/jkos.2009.50.9.1334.

Short-Term Effect of Intravitreal Bevacizumab Injection for Choroidal Neovascularization Associated With Degenerative Myopia

• Ryu JW
• Cho HK
• Lee WK

• KMID: 2212616
• DOI: http://doi.org/10.3341/jkos.2009.50.9.1334

Abstract

PURPOSE
To investigate the short-term effect of intravitreal bevacizumab injection for choroidal neovascularization associated with degenerative myopia. METHODS: In 15 eyes of 15 patients, one or two consecutive intravitreal bevacizumab injections were given. The best-corrected visual acuity (BCVA) and fundus examination were evaluated at baseline and monthly thereafter. Fluorescence angiography (FA) was performed at baseline, 1 month and 3 months after treatment. When the angiographic leakage persisted 1 month after the first injection, a second injection was administered. RESULTS: The mean follow-up period was 9.7 months. The mean logarithm of the minimum angle of resolution (LogMAR) BCVA was 0.81+/-0.44 at baseline, 0.64+/-0.41 at 3 months (p=0.005), and 0.60+/-0.41 (p=0.001) at the final examination. Five eyes received a single injection, while the other ten eyes had two consecutive injections. Three months after the first injection, 14 eyes (93.3%) had no angiographic leakage, and 1 eye (6.7%) showed a decrease in leakage. The mean lines of visual improvement at 3 months and at the final examination were 1.7 and 2.1 lines, respectively. No case of vision loss was observed throughout the follow-up period. CONCLUSIONS: One or two consecutive intravitreal bevacizumab injections had favorable short-term effects on visual acuity stabilization and the regression of choroidal neovascularization associated with neovascular degenerative myopia.

Keyword

Bevacizumab; Choroidal neovascularization; Degenerative myopia

MeSH Terms

Antibodies, Monoclonal, Humanized
Choroid
Choroidal Neovascularization
Eye
Fluorescein Angiography
Follow-Up Studies
Humans
Myopia, Degenerative
Vision, Ocular
Visual Acuity
Bevacizumab
Antibodies, Monoclonal, Humanized

Figure

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  Figure 1. A 62-year-old woman visited our clinic with metamorphopsia on the left eye (Case 15). At baseline, fundus photograph shows small amount of subretinal hemorrhage at the temporally juxtafoveal area and the nasally juxtafovel area (A). Fluorescein angiography (FA) shows hyperfluorescence in the early phase and increased leakage at the late phase from the nasally and temporally myopic CNV (B, C). At 3 months after single injection of intravitreal bevacizumab, fundus photograph shows resolution of the subretinal hemorrhage with RPE change in the myopic CNV (D). FA shows no evidence of leakage from the previous myopic CNV (E, F).

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  Figure 2. A 37-year-old woman visited our clinic with decreased visual acuity in the right eye (Case 2). At baseline, fundus photograph shows subretinal hemorrhage at the juxtafoveal area (A). Fluorescein angiography (FA) shows mild leakage atthe early phase and increased leakage at the late phase and (B, C). At 3 months after two consecutive injections of intravitreal bevacizumab, fundus photograph shows resolution of the retinal hemorrhage with fibrosis of the myopic CNV (D). FA shows no leakage but staining at the late phase (E, F).

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  Figure 3. Showing changes in the mean logarithm of the minimal angle of resolution (logMAR) best corrected visual acuity (BCVA) compared baseline with 3 months and final followup (∗ p=p value<0.05 was considered to be statistically significant).

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  Figure 4. Change in visual acuity at final examination after initial bivacizumab injection. All thirteen dots below the line indicate eyes with improved vision. Two eyes had stable visual acuity at baseline and 3 months (logMAR=logarithm of the minimal angle of resolution).

Reference

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