Intravitreal bevacizumab for choroidal neovascularisation in serpiginous choroiditis

Br J Ophthalmol. 2014 Apr;98(4):519-22. doi: 10.1136/bjophthalmol-2013-304237. Epub 2014 Jan 10.

Abstract

Purpose: To assess the effects of intravitreal bevacizumab (IVB) in the treatment of choroidal neovascularisation (CNV) secondary to serpiginous choroiditis (SC).

Design: Non-randomised, interventional case series.

Participants: Seven patients (seven eyes) affected by juxtafoveal CNV (six eyes) and subfoveal CNV (one eye) associated with SC were recruited.

Methods: Each patient underwent an ophthalmological examination, including measurement of best-corrected visual acuity (BCVA), fluorescein angiography (FA) and optical coherence tomography (OCT). After a first IVB injection (1.25 mg), patients were evaluated monthly over a 12-month follow-up. Further re-treatments were performed on the basis of detection of any type of fluid on OCT and/or presence of leakage on FA. The primary outcome considered was the median change in BCVA, as well as the proportion of eyes gaining at least 5 and 10 Early Treatment Diabetic Retinopathy Study (ETDRS) letters at the end of the 12-month follow-up. Secondary outcomes included median changes in central macular thickness (CMT) and number of injections over the planned follow-up.

Results: Median BCVA changed from 0.3 to 0.4 LogMAR. A functional improvement of at least 5 and 10 ETDRS letters was obtained in two eyes (28%) and one eye (14%), respectively, at the 12-month examination. Four eyes (57%) had stable BCVA, whereas one eye (14%) experienced a two-line decrease. Median CMT at baseline was 261 μm, decreasing to 196 μm at the 12-month examination. The median number of IVB injections was 1 in 12 months.

Conclusions: IVB can achieve anatomical stabilisation of CNV secondary to SC, avoiding a decline in visual acuity, in almost 90% of cases over a 12-month follow-up.

Keywords: Neovascularisation; Retina.

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use*
  • Bevacizumab
  • Choroidal Neovascularization / diagnosis
  • Choroidal Neovascularization / drug therapy*
  • Choroidal Neovascularization / etiology
  • Choroiditis / complications*
  • Choroiditis / diagnosis
  • Choroiditis / drug therapy
  • Female
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Prospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity / physiology

Substances

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