Intravitreal Bevacizumab in Inflammatory Ocular Neovascularization

• Published in: American journal of ophthalmology Vol. 146; no. 3; pp. 410 - 416.e1
• Main Authors: Mansour, Ahmad M, Mackensen, Friederike, Arevalo, J. Fernando, Ziemssen, Focke, Mahendradas, Padmamalini, Mehio-Sibai, Abla, Hrisomalos, Nicholas, Lai, Timothy Y.Y, Dodwell, David, Chan, Wai-Man, Ness, Thomas, Banker, Alay S, Pai, Sivakami A, Berrocal, Maria H, Tohme, Rania, Heiligenhaus, Arnd, Bashshur, Ziad F, Khairallah, Moncef, Salem, Khalil M, Hrisomalos, Frank N, Wood, Matthew H, Heriot, Wilson, Adan, Alfredo, Kumar, Atul, Lim, Lyndell, Hall, Anthony, Becker, Matthias
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2008; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal - therapeutic use; Antibodies, Monoclonal, Humanized; Bevacizumab; Biological and medical sciences; Child; Choroidal Neovascularization - drug therapy; Choroidal Neovascularization - etiology; Choroidal Neovascularization - physiopathology; Diabetic retinopathy; Eye Diseases - complications; Female; Follow-Up Studies; Humans; Injections; Macular degeneration; Male; Medical imaging; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Optic Disk - blood supply; Retinal Neovascularization - drug therapy; Retinal Neovascularization - etiology; Retinal Neovascularization - physiopathology; Retrospective Studies; Standard deviation; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity - physiology; Vitreous Body; Antineoplastic agent; Immunomodulator; Eye; Vascular endothelium growth factor; Ocular; Vitreous body; Inflammation; Monoclonal antibody; Neovascularization; Ophthalmology; Antiangiogenic agent; Bevacizumab
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2008.05.024

Purpose To assess the role of bevacizumab in inflammatory ocular neovascularization. Design Retrospective, multicenter, consecutive case series of inflammatory ocular neovascularization. Methods Patients with inflammatory ocular neovascularization of varying causes for whom standard therapy failed were treated with intravitreal injection of bevacizumab. Main outcome measures included improvement of best-corrected visual acuity (BCVA) expressed in logarithm of minimum angle of resolution units, response of inflammatory ocular neovascularization by funduscopy and angiography, and decrease in central foveal thickness as measured by optical coherence tomography at the three-month follow-up. Results At the three-month follow-up, 84 eyes of 79 patients had been treated with a mean of 1.3 injections (range, one to three). Thirty-four eyes showed juxtafoveal choroidal neovascularization (CNV), 34 eyes showed subfoveal CNV, eight eyes showed peripapillary CNV, and 11 eyes showed neovascularization of the disc (NVD) or neovascularization elsewhere (NVE). BCVA improved 2.4 lines from 0.68 (6/28 or 20/94) to 0.44 (6/17 or 20/55) ( P < .001). BCVA improved by one to three lines in 34.5% of the eyes, by four to six lines in 16.7% of the eyes, and by more than six lines in 14.2% of the eyes. Function was unchanged in 23.8% of the eyes. BCVA worsened in 10.7% (zero to three lines in 7.1%, more than four lines in 3.6%). Central foveal thickness decreased from baseline 346 to 252 μm ( P < .001). For CNV, 32 eyes (43.2%) had complete regression after the injection, 27 (36.5%) had partial regression, five (6.8%) had no response, and 10 eyes (13.5%) were not evaluated by the contributors. For NVD or NVE, seven eyes (63.6%) had complete regression of new vessels and four eyes (36.4%) had partial regression after the injection. Conclusions Intravitreal bevacizumab led to short-term significant visual improvement and regression of inflammatory ocular neovascularization in a wide variety of inflammatory ocular diseases.