title: Treatment of persistent serous retinal detachment in Vogt-Koyanagi-Harada syndrome with intravitreal bevacizumab during the systemic steroid treatment.
abstract: OBJECTIVE
  To report the use of bevacizumab in patients with Vogt-Koyanagi-Harada disease and persistent serous retinal detachment during the systemic steroid treatment.
  
  
  METHODS
  Four patients with bilateral Vogt-Koyanagi-Harada disease with the resolution of ocular inflammation presenting a serous retinal detachment involving the fovea that persisted for at least 1 month, despite systemic corticosteroid treatment, received an intravitreal injection of bevacizumab during the steroid tapering stage. Best-corrected visual acuity, central retinal thickness, and macular sensitivity were evaluated.
  
  
  RESULTS
  Of 8 eyes, 7 (87%) had complete resolution of subretinal fluid within 1 month following the treatment. After the treatment, the mean best-corrected visual acuity and macular sensitivity improved significantly (P < 0.001, analysis of variance). Compared with baseline, at all measurements, central retinal thickness decreased significantly (P < 0.01, Tukey-Kramer test). At 6 months, a significant correlation was found between best-corrected visual acuity and macular sensitivity in the central 8° (linear regression, r = -0.73; P = 0.03), whereas no correlation was found between central retinal thickness and both best-corrected visual acuity and macular sensitivity.
  
  
  CONCLUSIONS
  Intravitreal injection of bevacizumab during the corticosteroid therapy may be a treatment option for patients with decreased visual function because of persistent serous retinal detachment associated with Vogt-Koyanagi-Harada syndrome.
authors.affiliation: *Department of Ophthalmology, University of Catania, Catania, Italy; †Department of Ophthalmology, University of Napoli, Naples, Italy; ‡Department of Ophthalmology, University of Ancona, Ancona, Italy; and §Department of Ophthalmology, University of Foggia, Foggia, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Reibaldi
authors.forename: Andrea
authors.initials: A
authors.lastname: Russo
authors.forename: Teresio
authors.initials: T
authors.lastname: Avitabile
authors.forename: Maurizio G
authors.initials: MG
authors.lastname: Uva
authors.forename: Livio
authors.initials: L
authors.lastname: Franco
authors.forename: Antonio
authors.initials: A
authors.lastname: Longo
authors.forename: Mario D
authors.initials: MD
authors.lastname: Toro
authors.forename: Gilda
authors.initials: G
authors.lastname: Cennamo
authors.forename: Cesare
authors.initials: C
authors.lastname: Mariotti
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Neri
authors.forename: Nicola D
authors.initials: ND
authors.lastname: Noci
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Russo
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage* / Q000009:adverse effects; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000188:drug therapy* / Q000209:etiology; D013256:Steroids / Q000627:therapeutic use*; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications*; D014792:Visual Acuity
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D013256:Steroids; D000068258:Bevacizumab