title: Intravitreal bevacizumab for macular complications from retinal arterial macroaneurysms.
abstract: OBJECTIVE
  To evaluate the anatomic and functional results of the treatment with intravitreal bevacizumab in complicated retinal arterial macroaneurysm (RAM).
  
  
  METHODS
  A multicenter interventional, prospective, nonrandomized study.
  
  
  METHODS
  Thirty-eight macroaneurysms of 37 patients with foveal complications were evaluated. All patients underwent a comprehensive ophthalmologic examination, fluorescein angiography (FA), and spectral-domain optical coherence tomography (SD OCT) examination. Each patient underwent 3 monthly injections of bevacizumab 1.25 mg/0.05 mL; 3 follow-up visits were planned at week 2, 6, and 12.
  
  
  RESULTS
  Both best-corrected visual acuity (BCVA), expressed in logarithm of minimal angle of resolution (logMAR), and central retinal thickness (CRT) significantly improved during the follow-up visits (0.57 ± 0.21 vs 0.41 ± 0.15 vs 0.23 ± 0.13 vs 0.09 ± 0.10 and 520.38 ± 191.05 vs 396.24 ± 136.18 vs 283.86 ± 71.87 vs 214.84 ± 26.86, respectively, Friedman test P < .0001 for all variables). At 6 weeks of follow-up, FA showed complete closure of the RAM in 36 of 38 cases (94.7%). Four weeks following the third injection, the macular edema had completely resolved and hard exudates regressed slowly in 100% of patients.
  
  
  CONCLUSIONS
  Intravitreal bevacizumab is an effective therapy for complicated RAM, quickly improving BCVA and CRT. Anti-vascular endothelial growth factor (VEGF) drugs might actively close the involved pathologically permeabilized retinal artery and normalize the vessel wall formation by localized inhibition of VEGF.
authors.affiliation: San Giuseppe Hospital, University Eye Clinic, Milan, Italy. ilmiticopicchio@gmail.com
authors.forename: Francesco
authors.initials: F
authors.lastname: Pichi
authors.forename: Mariachiara
authors.initials: M
authors.lastname: Morara
authors.forename: Carlo
authors.initials: C
authors.lastname: Torrazza
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Manzi
authors.forename: Micol
authors.initials: M
authors.lastname: Alkabes
authors.forename: Nicole
authors.initials: N
authors.lastname: Balducci
authors.forename: Lucia
authors.initials: L
authors.lastname: Vitale
authors.forename: Andrea
authors.initials: A
authors.lastname: Lembo
authors.forename: Antonio P
authors.initials: AP
authors.lastname: Ciardella
authors.forename: Paolo
authors.initials: P
authors.lastname: Nucci
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000175:diagnosis / Q000188:drug therapy*; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000627:therapeutic use*; D000068258:Bevacizumab; D005122:Exudates and Transudates; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012161:Retinal Artery / Q000187:drug effects* / Q000473:pathology; D012164:Retinal Diseases / Q000175:diagnosis / Q000188:drug therapy*; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy; D058471:Subretinal Fluid; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab