MICROSTRUCTURAL EFFECTS OF INTRAVITREAL BEVACIZUMAB IN IDIOPATHIC CHOROIDAL NEOVASCULARISATION

Authors

  • Syed Nasir Ali Shah Department of Ophthalmology, First Affiliated Hospital of Xi’an Jiaotong University School of Medicine
  • Qian Yan Kang Department of Ophthalmology, First Affiliated Hospital of Xi’an Jiaotong University School of Medicine
  • Xiao Juan Fan Department of Ophthalmology, First Affiliated Hospital of Xi’an Jiaotong University School of Medicine
  • Faisal Shahbaz Cumberland Infirmary Hospital, Carlisle-England

Abstract

Background: Idiopathic choroidal neovascularization (ICNV) is a unilateral ocular disease which occurs in patients younger than 50 years and accounts for approximately 17% of patients with CNV. We evaluated microstructural effects of intravitreal bevacizumab in eyes with treatment-naïve idiopathic choroidal neovascularisation. Methods: In this case series study we reviewed the treatment and follow up records of 40 symptomatic eyes having ICNV, who received an intravitreal injection of bevacizumab (1.25 mg/0.05 mL) followed by additional doses based on optical coherence tomography findings, including intraretinal fluid, subretinal fluid, or pigment epithelial detachment. We analysed the results of best-corrected visual acuity, central retinal thickness, neovessels size (thickness and diameter), and disrupted photoreceptor length at baseline and at final visit with paired t-test. Difference in best corrected visual acuity was correlated with difference in optical coherence tomography parameters by Pearson’s correlation. Results: Mean logarithm of the minimum angle of resolution best-corrected visual acuity improved from 0.60 initially to 0.24 after treatment (p=0.01). Difference in mean central retinal thickness (82.65±44.1) µm, choroidal neovessels thickness (149.58±71.1) µm, choroidal neovessels diameter (1250.8±145.1) µm, photoreceptor disruption length (2141.20±318.8) µm were all statistically significant (p=0.01). Difference in best corrected visual acuity was correlated with optical coherence tomography parameters found no statistically significant difference. Conclusion: Intravitreal bevacizumab therapy is safe and well tolerated in ICNV eyes. Restoration of photoreceptor disruption length, decrease in central retinal thickness and choroidal neovessels size has association with visual improvement in idiopathic choroidal neovascularisation.Keywords: Idiopathic choroidal neovascularization, Cirrus HD-OCT, Subretinal fluids, Photoreceptor disruption length, Choroidal neovascularization

References

Ho AC, Yannuzzi LA, Pisicano K, DeRosa J. The natural history of idiopathic subfoveal choroidal neovascularization. Ophthalmology 1995;102(5):782–9.

Cohen SY, Laroche A, Leguen Y, Soubrane G, Coscas GJ. Etiology of choroidal neovascularization in young patients. Ophthalmology 1996;103(8):1241–4.

Byun YJ, Lee SJ, Koh HJ. Predictors of response after intravitreal bevacizumab injection for neovascular age-related macular degeneration. Jpn J Ophthalmol 2010;54(6):571–7.

Kim H, Lee K, Lee CS, Byeon SH, Lee SC. Subfoveal choroidal thickness in idiopathic choroidal neovascularization and treatment outcomes after intravitreal bevacizumab therapy. Retina 2015;35(3):481–6.

Zhang H, Liu ZL, Sun P, Gu F. Intravitreal Bevacizumab for treatment of Subfoveal Idiopathic Choroidal Neovascularization: Results of a 1-Year Prospective Trial. Am J Ophthalmol 2012;153(2):300–6.

Qi HJ, Li XX, Tao Y. Outcome of Intravitreal Bevacizumab for Idiopathic Choroidal Neovascularization in a Chinese Population. Can J Ophthalmol 2010;45(2):381–5.

Inoue M, Kadonosono K, Watanabe Y, Sato S, Kobayashi S, Yamane S et al. Results of 1-year follow-up examinations after intravitreal bevacizumab administration for idiopathic choroidal neovascularization. Retina 2010;30(5):733–8.

Yoo MH, Boo HD, Kim HK. Result of photodynamic therapy for idiopathic subfoveal choroidal neovascularization. Korean J Ophthalmol 2005;19(4):264–8.

Shin HJ, Chung H, Kim HC. Correlation of foveal microstructural with vision after anti-vascular endothelial growth factor therapy in age-related macular degeneration. Retina 2013;33(5):964–70.

Framme C, Panagakis G, Birngruber R. Effects on choroidal neovascularization after anti-VEGF Upload using intravitreal ranibizumab, as determined by spectral domain-optical coherence tomography. Invest Ophthalmol Vis Sci 2010;51(3):1671–6.

Byun YJ, Lee SJ, Koh HJ. Predictors of response after intravitreal bevacizumab injection for neovascular age-related macular degeneration. Jpn J Ophthalmol 2010;54(6):571–7.

Published

2015-06-20