Intravitreal Injection of Bevacizumab for the Treatment of Choroidal Neovascularization in a Patient with Angioid Streaks

We report the favorable outcome of intravitreal injection of bevacizumab (Avastin) to treat choroidal neovascularization (CNV) secondary to angioid streaks in an 82-year-old Chinese man. Within 2 weeks of bevacizumab injection, visual acuity improved from 20/40 to 20/25 and optical coherence tomography revealed complete resolution of CNV and retinal edema. The juxtafoveal hemorrhage nearly disappeared, and the size of CNV markedly regressed from 1,200 mu m to unremarkable on fluorescein angiography. These improvements were maintained after 2 additional doses of intravitreal bevacizumab administered at 4-week intervals. No ocular or systemic side effects were observed. Neither recurrent CNV lesion nor new hemorrhage was noted during 18 months of follow-up. The short-term results suggest that intravitreal injection of bevacizumab for the treatment of CNV in patients with angioid streak is well tolerated and highly effective. It may be a promising pharmacologic treatment option since limited therapies are available for this disease with a rather aggressive course. [J Chin Med Assoc 2009;72(2):98-102]