Intravitreal bevacizumab for refractory pigment epithelial detachment with occult choroidal neovascularization in age-related macular degeneration.

Abstract

PURPOSE:

New medications targeting vascular endothelial growth factor show promise in the treatment of wet macular degeneration. This study describes the clinical response and optical coherence tomography (OCT) findings for patients with refractory pigment epithelial detachment (PED) and occult choroidal neovascular membranes (CNVMs) who were treated with intravitreal bevacizumab.

METHODS:

A retrospective analysis of data for 10 patients with fibrovascular PEDs, initially treated with intravitreal pegaptanib, thermal laser, or photodynamic therapy with or without triamcinolone acetonide administration, was performed. All patients were refractory to previous treatment. They received monthly injections of bevacizumab and were followed by clinical examination, angiography, and OCT.

RESULTS:

Nine of 10 patients had stable or improved vision. Angiogram findings showed resolution of leakage from CNVMs. OCT demonstrated resolution of the subretinal or intraretinal fluid but persistence of the PED itself. Vision improvement was correlated with OCT changes.

CONCLUSION:

Intravitreal bevacizumab may be a viable option in treating patients with fibrovascular PEDs. OCT findings suggest that visual improvement is secondary to resolution of subretinal and intraretinal edema without resolution of the PED.

• Authors: Eric Chen, Richard S Kaiser, James F Vander
• Journal: Retina (Philadelphia, Pa.) (Retina) 2007 Apr-May Vol. 27 Issue 4 Pg. 445-50 ISSN: 0275-004X [Print] United States
• PMID: 17420696 (Publication Type: Journal Article)

Chemical References

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

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Antibodies, Monoclonal (therapeutic use)
• Antibodies, Monoclonal, Humanized
• Bevacizumab
• Choroidal Neovascularization (diagnosis, drug therapy, etiology)
• Female
• Fluorescein Angiography
• Humans
• Injections
• Macular Degeneration (complications, diagnosis)
• Male
• Pigment Epithelium of Eye (drug effects, pathology)
• Retinal Detachment (diagnosis, drug therapy, etiology)
• Retrospective Studies
• Tomography, Optical Coherence
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity
• Vitreous Body