Histological findings of a choroidal neovascular membrane removed at the time of macular translocation in a patient previously treated with intravitreal bevacizumab treatment (Avastin).
OBJECTIVE
To report the findings in a patient treated by repeated intravitreal bevacizumab (Avastin) injections, followed by macular relocation and excision of subfoveal choroidal neovascular membrane (CNV).


METHODS
Histopathological evaluation of the CNV specimen, including immunohistochemical assessment.


RESULTS
During surgical excision, the CNV seemed to be avascular and its underlying bed did not bleed. Histopathological examination revealed that the CNV comprised avascular fibrous subretinal tissue containing fibroblastic retinal pigment epithelial (RPE) cells, fragments of irregular thickened Bruch's membrane and fibrotic choroidal tissue containing some medium-sized vessels but no choriocapillaris.


CONCLUSIONS
The development of an RPE tear during the course of Avastin treatment may reflect contraction of the avascular subretinal tissue, whereas the lack of capillaries in both choroidal and subretinal components may be caused by the increased access of Avastin to the choriocapillaris in the presence of the RPE tear.
Gibran
S K
SK
St Paul's Eye Unit, Royal Liverpool Hospital, Liverpool L7 8XP, UK. syedgibran@yahoo.com
Sachdev
A
A
Stappler
T
T
Newsome
R
R
Wong
D
D
Hiscott
P
P
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D004333:Drug Administration Routes; D006801:Humans; D008268:Macular Degeneration / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab