Results of 1-year follow-up examinations after intravitreal bevacizumab administration for idiopathic choroidal neovascularization.
ABSTRACT The purpose of this study was to report the results of 1-year follow-up examinations after intravitreal bevacizumab injection for the treatment of idiopathic choroidal neovascularization.
Seven eyes in 7 patients with idiopathic choroidal neovascularization were intravitreally injected with 1.25 mg/0.05 mL of bevacizumab. The need for retreatment was evaluated if spectral-domain optical coherence tomography showed intraretinal edema or subretinal fluid at the time of a 1-month follow-up examination. Fluorescein angiography was performed 1 year after the first injection. The primary outcome measures were best-corrected visual acuity and central foveal thickness using spectral-domain optical coherence tomography.
All 7 eyes were assessed at a 1-year follow-up examination. The mean number of injections per eye was 2.7. The mean logarithm of the minimum angle of resolution best-corrected visual acuity improved significantly from 0.31 +/- 0.29 to 0.15 +/- 0.38 (P < 0.05). The mean central foveal thickness decreased from 332 +/- 83 microm to 261 +/- 66 microm (P < 0.01). Fluorescein angiography showed no leakage at 1 year in all eyes. All patients whose best-corrected visual acuity improved by > or =0.2 logarithm of the minimum angle of resolution had a visual acuity of > or =20/40 when first injected at baseline.
The intravitreal injection of bevacizumab is effective for stabilizing or improving vision in patients with idiopathic choroidal neovascularization, as evaluated at a 1-year follow-up examination. In particular, this treatment may be well tolerated in patients with a visual acuity of > or =20/40 at baseline. Additional investigations are needed to assess the long-term safety and the optimal protocol for intravitreal bevacizumab administration.
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ABSTRACT: To evaluate the safety and efficacy of intravitreal injection of ranibizumab 0.5mg in the treatment of idiopathic choroidal neovascularisation in young patients, which is the second most common cause of macular CNV in patients under 50 years of age. This single-center, prospective, interventional, uncontrolled, nonrandomized clinical case series study included 13 eyes of 13 consecutive young patients with idiopathic macular choroidal neovascularisation treated with monthly intravitreal injections of 0.5mg ranibizumab. Prior to treatment, measurement of best-corrected visual acuity (BCVA), fundus examination, fluorescein angiography (FA) and macular optical coherence tomography (OCT) were performed. Measurement of visual acuity, fundus exam and OCT were repeated each month. A repeated monthly injection was performed in the event of persistence or recurrence of neovascular activity. Ten women and three men, mean age 34±7.88 years at time of diagnosis, were included in the study. Mean best-corrected visual acuity improved dramatically throughout the study, going from 0.74 LogMar at enrolment to 0.45 LogMar at 13 months (P<10(-6)). On average, two intravitreal injections of ranibizumab (0.5mg) were required during this year. Mean follow-up was 13±7.6 months. Management of idiopathic CNV in young patients is difficult, due to frequent recurrences despite treatment. Argon laser photocoagulation, photodynamic therapy, and subretinal surgery offer limited results in terms of visual recovery and recurrence. Intravitreal ranibizumab injection appears to be safe and effective for treatment of idiopathic macular CNV in young patients. A longer-term prospective trial is required to corroborate these results.Journal francais d'ophtalmologie 07/2012; 35(7):514-22. DOI:10.1016/j.jfo.2011.10.015 · 0.36 Impact Factor
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ABSTRACT: Background. To compare visual outcomes and spectral-domain optical coherence tomography results following intravitreal ranibizumab treatment for early and mid-idiopathic choroidal neovascularization (ICNV). Methods. This retrospective, case-controlled study examined 44 patients with ICNV in one eye initially treated with intravitreal ranibizumab (0.5 mg). Further intravitreal treatments were administered as necessary. Patients were divided into two groups according to disease duration, that is, ≤3 months or 3-6 months (early and mid-groups), and the data were compared. Results. All patients completed at least 12 months of follow-up. Significant differences were observed between the groups in best-corrected visual acuity and in central macular thickness (CMT) reduction at all five follow-up visits. At the last follow-up (12 months), 19 early group eyes (79.1%) and 10 mid group eyes (50.0%) had statistically significant visual gains of >15 early treatment diabetic retinopathy study (ETDRS) letters (χ (2) = 4.130, P = 0.042). The mean number of injections was significantly higher (P = 0.0001) in the mid group (2.53 ± 1.76) than in the early group (1.22 ± 1.01). Conclusions. Early intravitreal ranibizumab for ICNV can result in better visual prognoses, more obvious decreases in CMT, and fewer injections.Journal of Ophthalmology 04/2014; 2014:382702. DOI:10.1155/2014/382702 · 1.94 Impact Factor
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ABSTRACT: PURPOSE: To compare visual outcomes after intravitreal anti-vascular endothelial growth factor (VEGF) injection or photodynamic therapy (PDT) for idiopathic choroidal neovascularization (CNV). DESIGN: Retrospective study. METHODS: Among 29 eyes (28 patients), 15 eyes (15 patients) received anti-VEGF therapy and 14 eyes (13 patients) received PDT. Best-corrected visual acuity (BCVA, logMAR [logarithm of minimal angle of resolution]) at baseline and 1, 3, 6, 12, and 24 months after initial treatment were compared. The eyes were classified by BCVA changes: improved (improvement ≥0.3 logMAR), decreased (deterioration ≥0.3 logMAR), and stable. RESULTS: Mean BCVA was 0.56 ± 0.38 logMAR (20/72 in Snellen equivalent) in the PDT group and 0.44 ± 0.59 logMAR (20/55 in Snellen equivalent) in the anti-VEGF group at baseline (P = .104, Mann-Whitney U test). The anti-VEGF group showed significantly better mean BCVA at each follow-up visit when compared with that of PDT (P = .004 at 1 month, P = .002 at 3 months, P = .037 at 6 months, P = .031 at 12 months, and P = .049 at 24 months; Mann-Whitney U test, respectively). When compared with the baseline, mean BCVA at each follow-up visit was better in the anti-VEGF group (P = .196 at 1 month, P = .007 at 3 months, P = .046 at 6 months, P = .046 at 12 months, and P = .049 at 24 months; Wilcoxon signed rank test, respectively), whereas BCVA in the PDT group was not. At 24 months, all eyes (100.0%) treated with anti-VEGF showed stable or improved BCVA, whereas 3 eyes (21.3%) showed visual deterioration after PDT. CONCLUSIONS: Anti-VEGF therapy was superior to PDT for idiopathic CNV, and superior efficacy was sustained until 24 months.American Journal of Ophthalmology 12/2012; DOI:10.1016/j.ajo.2012.10.010 · 4.02 Impact Factor