Long-term Therapeutic Effect of Intravitreal Bevacizumab (Avastin) on Myopic Choroidal Neovascularization

Young Seung Seo; Moo Hwan Chang

doi:10.3341/jkos.2011.52.1.34

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Seo and Chang: Long-term Therapeutic Effect of Intravitreal Bevacizumab (Avastin) on Myopic Choroidal Neovascularization

Original Article

J Korean Ophthalmol Soc 2011;52(1):34-40.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.1.34

Long-term Therapeutic Effect of Intravitreal Bevacizumab (Avastin) on Myopic Choroidal Neovascularization

Young Seung Seo, MD, Moo Hwan Chang, MD, PhD

Department of Ophthalmology, Dankook University Hospital, Cheonan, Korea

Address reprint requests to Moo Hwan Chang, MD, PhD Department of Ophthalmology, Dankook University Hospital San 16-5, Anseo-dong San 16-5, Cheonan 330-715, Korea Tel: 82-41-550-6497, Fax: 82-41-561-0137, E-mail: changmh@dankook.ac.kr

Received 14 June 2010 Revised 1 October 2010 Accepted 25 November 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the long-term therapeutic effects of intravitreal bevacizumab on myopic choroidal neovascularization (CNV).

Methods

Medical records of 6 patients who underwent intravitreal bevacizumab injection for myopic CNV and were followed for more than 2 years, were retrospectively investigated. The best corrected visual acuity was compared at 1,3,12, and 24 months after injection. Two years after the injection, a fluorescein angiography and optical coherence tomography (OCT) were performed to evaluate the central macular thickness and leakage of CNV.

Results

The mean best corrected visual acuity was 1.16 ± 0.43 (logMAR), 0.45 ± 0.21 (logMAR), 0.29 ± 0.23 (logMAR), 0.14 ± 0.11 (logMAR), and 0.11 ± 0.06 (logMAR) at baseline, 1, 3, 12, and 24 months after injection, respectively. The average number of injections was 1.33. In OCT, 2 years after bevacizumab injection, central foveal thickness was significantly decreased as compared to the baseline, and fluorescein angiography showed no leakage of fluorescein.

Conclusions

Intravitreal bevacizumab injection for the treatment of myopic CNV was effective in maintaining post-operative visual acuity for 2 years.

Keywords: Bevacizumab, Choroidal neovascularization, Intravitreal injection, Long-term, Myopic CNV

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Figure 1.

Mean best corrected visual acuity at baseline, 1, 3, 12, and 24 months. After intravitreal bevacizumab injection, graph shows to maintenance of good visual acuity until 2 years later (p = 0.042, p = 0.028, p = 0.042, p = 0.028, Wilcoxon signed rank test).

Figure 2.

Best corrected visual acuity in each of six cases. Most cases maintain improved visual acuity until 2 years later.

Figure 3.

CMT at preinjection and 2-years later after injection. Graph shows to maintenance of decreased central macular thickness until 2 years later (p = 0.01, Wilcoxon signed rank test).

Figure 4.

Serial fundus photographs and fluorescein angiographs and optical coherence tomographs of case 6. (A) images before intravitreal bevacizumab injection showed subfoveal hemorrhage and juxtafoveal classic CNV and macular edema. At this time BCVA was 0.02 (logMAR 1.70). At 1 year after intravitreal bevacizumab injection, (B) images showed scar change of CNV membrane and just fluorescein staining without fluorescein leakage. BCVA at 1 year was 1.0 (logMAR 0.00). At 2 years after intravitreal bevacizumab injection, (C) images showed similar findings at (B) images. BCVA at 2 year was 0.9 (logMAR 0.04). Until two years later, very good and stable prognosis has been shown.

Table 1.

Patient characteristics

Pt. case no.	e Sex	Age	eye	Refractive error (diopters)	BCVA^† (log MAR^‡)					location	CMT^§ (μ m)		No. of injections
Pt. case no.	e Sex	Age	eye	Refractive error (diopters)	Month 0	1	3	12	24	location	Month 0	24	No. of injections
1	F	46	L	−12	0.70	0.30	0.15	0.20	0.15	Subfovea	440	275	1
2	M	44	R	−9.25	1.10	0.30	0.04	0.04	0.04	Subfovea	300	269	2
3^*	M	55	L	−13	0.80	0.70	0.70	0.30	0.10	Subfovea	295	279	1
4	M	51	L	−8	1.00	0.20	0.15	0.15	0.15	Subfovea	350	240	2
5	F	20	L	−11	1.70	0.50	0.30	0.20	0.20	Subfovea	298	181	1
6	F	15	R	−9	1.70	0.70	0.40	0.00	0.04	juxtafovea	420	244	1
Mean		38.5		−10.37	1.16	0.45	0.29	0.14	0.11		350.5	248	1.33
SD		16.7		1.93	0.43	0.21	0.23	0.11	0.06		65.1	36.6	0.51
	F:3		R;2							Subfovea:5			
	M:3		L:4							Juxtafovea:1			

^* Underwent cataract operation at 9 months after injection. At 12 months, visual acuity showed greater improvement.

^† BCVA = best corrected visual acuity

^‡ LogMAR = logarithm of the minimum angle of resolution

^§ CMT = central macular thickness.

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