Long-term visual outcomes of intravitreal bevacizumab in inflammatory ocular neovascularization.
OBJECTIVE
To assess the long-term role of bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) in inflammatory ocular neovascularization.


METHODS
Retrospective multicenter consecutive case series of inflammatory ocular neovascularization.


METHODS
settings: Multicenter institutional and private practices.


METHODS
Patients with inflammatory ocular neovascularization in one or both eyes of varying etiologies who failed standard therapy. intervention: Intravitreal injection of bevacizumab.


METHODS
Improvement of best-corrected visual acuity (BCVA) expressed as logarithm of minimal angle of resolution (logMAR), and decrease in central foveal thickness as measured by optical coherence tomography at 6, 12, 18, and 24 months of follow-up.


RESULTS
Mean logMAR BCVA (central foveal thickness) following intravitreal bevacizumab was as follows: baseline, 0.65 (6/27 or 20/90) (338 microm; 99 eyes of 96 patients); 6 months, 0.42 (6/16 or 20/53) (239 microm; 2.0 injections; 81 eyes); 12 months, 0.39 (6/15 or 20/49) (241 microm; 2.3 injections; 95 eyes); 18 months, 0.40 (6/15 or 20/50) (261 microm; 3.0 injections; 46 eyes); and 24 months, 0.34 (6/13 or 20/44) (265 microm; 3.6 injections; 27 eyes). Paired comparisons revealed significant visual improvement at 6 months of 2.4 lines (P = .000), at 12 months of 2.5 lines (P = .000), at 18 months of 2.5 lines (P = .001), and at 24 months of 2.2 lines (P = .013). Paired comparisons revealed significant central foveal flattening at 6 months of 78 microm (P = .000), at 12 months of 85 microm (P = .000), at 18 months of 90 microm (P = .003), and at 24 months of 77 microm (P = .022). Three eyes developed submacular fibrosis and 1 eye submacular hemorrhage.


CONCLUSIONS
Intravitreal bevacizumab led in the long-term to significant mean visual improvement of > or =2.2 lines and significant foveal flattening in a wide variety of inflammatory ocular diseases without major complications.
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; Rafic Hariri University Hospital, Beirut, Lebanon.
Ahmad M
AM
Mansour
J Fernando
JF
Arevalo
Focke
F
Ziemssen
Abla
A
Mehio-Sibai
Friederike
F
Mackensen
Alfredo
A
Adan
Wai-Man
WM
Chan
Thomas
T
Ness
Alay S
AS
Banker
David
D
Dodwell
Thi Ha
TH
Chau Tran
Christine
C
Fardeau
Phuc
P
Lehoang
Padmamalini
P
Mahendradas
Maria
M
Berrocal
Zuheir
Z
Tabbarah
Nicholas
N
Hrisomalos
Frank
F
Hrisomalos
Khalil
K
Al-Salem
Rainer
R
Guthoff
D000328:Adult; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000503:physiopathology; D002833:Choroiditis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008297:Male; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014605:Uveitis / Q000188:drug therapy* / Q000503:physiopathology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology*; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab