Treatment of persistent serous retinal detachment in Vogt-Koyanagi-Harada syndrome with intravitreal bevacizumab during the systemic steroid treatment.

Abstract

PURPOSE:

To report the use of bevacizumab in patients with Vogt-Koyanagi-Harada disease and persistent serous retinal detachment during the systemic steroid treatment.

METHODS:

Four patients with bilateral Vogt-Koyanagi-Harada disease with the resolution of ocular inflammation presenting a serous retinal detachment involving the fovea that persisted for at least 1 month, despite systemic corticosteroid treatment, received an intravitreal injection of bevacizumab during the steroid tapering stage. Best-corrected visual acuity, central retinal thickness, and macular sensitivity were evaluated.

RESULTS:

Of 8 eyes, 7 (87%) had complete resolution of subretinal fluid within 1 month following the treatment. After the treatment, the mean best-corrected visual acuity and macular sensitivity improved significantly (P < 0.001, analysis of variance). Compared with baseline, at all measurements, central retinal thickness decreased significantly (P < 0.01, Tukey-Kramer test). At 6 months, a significant correlation was found between best-corrected visual acuity and macular sensitivity in the central 8° (linear regression, r = -0.73; P = 0.03), whereas no correlation was found between central retinal thickness and both best-corrected visual acuity and macular sensitivity.

CONCLUSION:

Intravitreal injection of bevacizumab during the corticosteroid therapy may be a treatment option for patients with decreased visual function because of persistent serous retinal detachment associated with Vogt-Koyanagi-Harada syndrome.

• Authors: Michele Reibaldi, Andrea Russo, Teresio Avitabile, Maurizio G Uva, Livio Franco, Antonio Longo, Mario D Toro, Gilda Cennamo, Cesare Mariotti, Piergiorgio Neri, Nicola D Noci, Vincenzo Russo
• Journal: Retina (Philadelphia, Pa.) (Retina) Vol. 34 Issue 3 Pg. 490-6 (Mar 2014) ISSN: 1539-2864 [Electronic] United States
• PMID: 23903795 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• Steroids
• Bevacizumab

Topics

• Adult
• Analysis of Variance
• Angiogenesis Inhibitors (administration & dosage, adverse effects)
• Antibodies, Monoclonal, Humanized (administration & dosage, adverse effects)
• Bevacizumab
• Female
• Humans
• Intravitreal Injections
• Male
• Middle Aged
• Retinal Detachment (drug therapy, etiology)
• Steroids (therapeutic use)
• Uveomeningoencephalitic Syndrome (complications)
• Visual Acuity