Bevacizumab for the treatment of pediatric retinal and choroidal diseases.
OBJECTIVE
To determine the efficacy of off-label intravitreal bevacizumab (IVB) for the treatment of pediatric retinal and choroidal vascular diseases.


METHODS
Retrospective, non-comparative, open-label, interventional, consecutive case series of all patients younger than 18 years treated with off-label IVB at a single center from January 1, 2005, to January 1, 2008. Primary outcome measures with best-corrected visual acuity by age-appropriate testing and central macular thickness by time-domain optical coherence tomography.


RESULTS
Thirty-five eyes of 33 patients were treated with IVB alone or in combination with other treatments for choroidal neovascularization, Coats' disease, familial exudative vitreoretinopathy, and various other indications. IVB was used in 24 eyes to reduce excess retinal fluid and exudation. Mean Snellen visual acuity improved from 20/170 at baseline to 20/100 at 1 month (P = .006), 20/80 at 3 months (P = .006), and 20/50 at 6 months (P = .023). Central macular thickness improved from 356 μm at baseline to 287 μm at 6 months (P = .028). IVB was used in 11 eyes to control peripheral retinal neovascularization and iris rubeosis. Although IVB reduced vascular engorgement, it did not prevent the progression of preretinal tractional forces. Mean visual acuity was maintained at each time point. No systemic or ocular adverse events were directly attributable to IVB in any patient.


CONCLUSIONS
IVB reduced vascular leakage and temporarily regressed pathologic neovascularization of the choroid, retina, and iris in this series of pediatric patients. Further prospective studies are warranted.
Sisk
Robert A
RA
Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL, USA. rsisk@med.miami.edu
Berrocal
Audina M
AM
Albini
Thomas A
TA
Murray
Timothy G
TG
D000293:Adolescent; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002648:Child; D002675:Child, Preschool; D015862:Choroid Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D020256:Choroidal Neovascularization / Q000188:drug therapy; D005128:Eye Diseases / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology; D005139:Eyeglasses; D005260:Female; D005654:Fundus Oculi; D006801:Humans; D007223:Infant; D058449:Intravitreal Injections; D008266:Macula Lutea / Q000187:drug effects / Q000473:pathology; D008297:Male; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D058456:Retinal Telangiectasis / Q000188:drug therapy; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab