Three-year visual and anatomic results of administrating intravitreal bevacizumab in inflammatory ocular neovascularization.
OBJECTIVE
To assess the 3-year visual outcome of intravitreal bevacizumab in inflammatory ocular neovascularization.


METHODS
Experimental study.


METHODS
Retrospective multicenter consecutive case series in 81 patients with inflammatory ocular neovascularization refractory to standard therapy and treated with intravitreal bevacizumab. The outcome measures included improvement of best corrected visual acuity expressed as logarithm of minimum angle of resolution (logMAR) and paired comparison decrease in central foveal thickness by optical coherence tomography.


RESULTS
Mean best corrected visual acuity improved from baseline 0.699 (6/30 or 20/101) (SD 0.434) to 0.426 (6/16 or 20/53) (SD 0.428) (n = 81; p < 0.001), a gain of 2.7 lines (median 3 injections; 81 eyes; 81 patients). Paired comparisons revealed significant central foveal flattening at 3 years of 97.9 μm (n = 51; p < 0.001). In a subgroup analysis, visual improvement was significant for ocular histoplasmosis (p = 0.026); multifocal choroiditis (p = 0.05); serpiginous choroiditis (p = 0.028); ocular toxoplasmosis (p = 0.042); and punctate inner choroidopathy (p = 0.015). In a subgroup analysis, foveal flattening was significant for ocular histoplasmosis (p = 0.004); multifocal choroiditis (p = 0.007); serpiginous choroiditis (p = 0.011); and punctate inner choroidopathy (p = 0.001). Of the group, 5 eyes developed submacular fibrosis, 1 eye retinal pigment epithelial tear, and 1 eye macular ischemia in the context of vasculitis.


CONCLUSIONS
At 3 years, intravitreal bevacizumab sustained significant visual improvement of 2.7 lines and significant foveal flattening of 98 μm in a wide variety of inflammatory ocular diseases without major complications after a median of 3 injections.
Department of Ophthalmology, American University of Beirut, Beirut, Lebanon. ammansourmd@gmail.com
Ahmad M
AM
Mansour
J Fernando
JF
Arevalo
Christine
C
Fardeau
Emily N
EN
Hrisomalos
Wai-Man
WM
Chan
Timothy Y Y
TY
Lai
Focke
F
Ziemssen
Thomas
T
Ness
Abla Mehio
AM
Sibai
Friederike
F
Mackensen
Armin
A
Wolf
Nicholas
N
Hrisomalos
Arnd
A
Heiligenhaus
Georg
G
Spital
Yukari
Y
Jo
Fumi
F
Gomi
Yasushi
Y
Ikuno
Jad
J
Akesbi
Phuc
P
LeHoang
Alfredo
A
Adan
Padmamalini
P
Mahendradas
Moncef
M
Khairallah
Rainer
R
Guthoff
Blanche
B
Ghandour
Cem
C
Küçükerdönmez
Shree K
SK
Kurup
D000293:Adolescent; D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D017024:Chemotherapy, Adjuvant; D002648:Child; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000503:physiopathology; D002833:Choroiditis / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology*; D012189:Retrospective Studies; D013997:Time Factors; 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*
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D007166:Immunosuppressive Agents; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab