Intravitreal bevacizumab (Avastin) as treatment for subfoveal choroidal neovascularisation secondary to pathological myopia

Objective: To evaluate the safety and efficacy of intravitreal bevacizumab ( Avastin) as treatment for subfoveal choroidal neovascularisation ( CNV) due to pathological myopia. Methods: Consecutive series of primary or recurrent subfoveal CNV secondary to myopia treated with intravitreal bevacizumab 1.25 mg between August 2005 and January 2006 at the New England Eye Center, Boston, Massachusetts, USA, were reviewed retrospectively. Data from clinical examination, fundus photography, fluorescein angiography, optical coherence tomography and visual acuity were collected. Results: There were 11 eyes of 9 patients. 5 of 11 eyes had been treated previously with photodynamic therapy. Pre-injection visual acuity measured 20/50 to 20/100 in 6 eyes and 20/200 or worse in 5 eyes. After a mean follow-up of 153 ( range 35-224) days, post-injection visual acuity measured 20/20 to 20/40 in 7 eyes, 20/50 to 20/100 in 1 eye and 20/200 or worse in 3 eyes. Three eyes received two bevacizumab injections and eight eyes received one injection. Visual acuity improved by a mean of +3.5 ( range -1 to +8 lines) lines, and 8 of 11 eyes achieved 20/50 or better at the last follow-up. Central foveal thickness improved from 340 ( range 253-664) mu m to 234 ( range 142-308) mu m, representing an average reduction of 103 ( range +4 to -356) mu m. No injection complications or drug-related side effects were observed. Conclusions: In this small series of eyes with limited follow-up, intravitreal bevacizumab seems to be safe and potentially efficacious in eyes with subfoveal CNV secondary to pathological myopia.