Long-term Results of Intravitreal Bevacizumab Injection for Choroidal Neovascularization Secondary to Angioid Streaks

摘要

Purpose: To investigate the long-term efficacy of intravitreal injections of bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) for choroidal neovascularization (CNV) secondary to angioid streaks. Design: Observational case series. Methods: Fifteen eyes of 13 patients (5 men, 8 women; mean age, 59 years; range, 54 to 70 years) treated with 1-mg intravitreal bevacizumab injections were included. The minimum follow-up after the first injection was 12 months. Eyes that had undergone previous treatments were excluded. The best-corrected visual acuity (BCVA) was measured. Optical coherence tomography and fluorescein angiography images were examined before and after treatment. Results: The mean follow-up was 19 months (range, 12 to 24 months). The mean number of injections for primary CNV was 4.5 (range, 1 to 9). The mean preoperative BCVA (decimal equivalent) was 0.39 (range, 0.08 to 1.5) and 0.47 (range, 0.06 to 1.2) at the final visit (P = .355). The BCVA improved by 2 lines of logarithm of the minimum angle of resolution visual acuity at the final visit in 5 eyes (33%), was unchanged in 8 eyes (54%), and decreased in 2 eyes (13%). The final fluorescein angiography examination showed no leakage in 10 eyes (67%), minimal leakage in 2 eyes (13%), and persistent or recurrent leakage in 3 eyes (20%). Five eyes (33%) had a recurrence 4 to 7 months (mean, 5.1 months) after the last bevacizumab injection. New CNV lesions developed in different areas in 3 eyes (20%) 6 to 14 months after the last bevacizumab injection for primary CNV. Conclusions: An intravitreal injection of bevacizumab seems to maintain visual acuity. However, CNV frequently recurred or new CNV developed during the long follow-up.