Original article
Bevacizumab in Inflammatory Eye Disease

https://doi.org/10.1016/j.ajo.2009.06.010Get rights and content

Purpose

To report the effect of intravitreal bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) on visual acuity and macular thickness in patients with inflammatory choroidal neovascularization (CNV) or cystoid macular edema (CME).

Design

Retrospective, noncomparative, interventional case series.

Methods

Each eye received 1.25 mg of intravitreal bevacizumab at baseline. Follow-up examinations were scheduled at 1- to 2-month intervals, with additional injections at the discretion of the physician. Comprehensive evaluations, including Snellen best-corrected visual acuity (BVCA) and optical coherence tomography measurements, were performed at each visit. Main outcome measures were BCVA and central subfield thickness (CST), as measured by optical coherence tomography.

Results

Thirty-four eyes of 30 patients with inflammatory CNV (n = 21 eyes of 19 patients; 9 male, 10 female) or CME (n = 13 eyes of 11 patients; 4 male, 7 female) were identified. Median ages were 52 years (range, 7 to 83) and 67 years (range, 17 to 83) for the CNV and CME groups, respectively. The median length of follow-up for CNV eyes was 7 months (range, 1 to 28) while the median follow-up for CME eyes was 13 months (range, 1 to 20). Both groups received a median of two injections (range, 1 to 9 for CNV and 1 to 4 for CME). For eyes with CNV, BCVA improved significantly at follow-up month 1, but was not different from baseline thereafter; CST remained unchanged throughout follow-up. For eyes with CME, neither BCVA nor CST changed significantly over the course of follow-up.

Conclusions

Bevacizumab appears to stabilize BCVA and CST for eyes with inflammatory CNV or CME.

Section snippets

Methods

We performed a retrospective chart review of eyes treated with intravitreal bevacizumab for uveitic CNV or CME through February 1, 2008. A computerized search of billing codes was used to identify eligible patients at the Bascom Palmer Eye Institute. Inclusion criteria consisted of a diagnosis of inflammatory CNV or CME, treatment with at least one injection of intravitreal bevacizumab, and follow-up of at least 1 month. Eyes were excluded if they had received sub-Tenon or intravitreal

Results

TABLE 1, TABLE 2 summarize demographic and ophthalmic results. Thirty-four eyes of 30 patients met inclusion criteria; an additional 4 eyes were excluded because they had received sub-Tenon or intravitreal corticosteroids during the 12 weeks preceding bevacizumab injection. Twenty-one eyes of 19 patients (9 male, 10 female) with a median age of 52 years (range, 7 to 83) demonstrated CNV while 13 eyes of 11 patients (4 male, 7 female) with a median age of 67 years (range, 17 to 83) demonstrated

Discussion

Although case reports have described favorable outcomes in cases of inflammatory CNV and CME treated with intravitreal bevacizumab,25, 26, 27, 28 larger series contain less consistent results. Adan and associates, for example, retrospectively reviewed the outcomes of 9 eyes treated with intravitreal bevacizumab for uveitic CNV.29 Over a mean follow-up of 7.1 months, they found that BCVA improved in 8 eyes (88.8%) and stabilized in 1 (11.2%); foveal thickness decreased in all eyes, a result that

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