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

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 (ranged 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 (1.3%). 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. (Am J Ophthalmol 2009;148:584-590. (C) 2009 by Elsevier Inc. All rights reserved.)