Choroidal Neovascularization Clinical Trial
Official title:
Intravitreal Bevacizumab for Choroidal Neovascularization Secondary to Angioid Streaks: 24 Months Follow-up
The purpose of this study is to investigate the safety and efficacy of intravitreal bevacizumab in patients with choroidal neovascularization associated with angioid streaks.
To investigate the safety and efficacy of intravitreal bevacizumab in a patient with
choroidal neovascularization associated with angioid streaks. One of the most serious ocular
complication of angioid streaks is the occurrence of choroidal neovascularization (CNV) and
because of the implication of the macula, this complication usually leads to central vision
loss.
During the past, laser photocoagulation, first, and photodynamic therapy (PDT), more
recently, have been used as treatment for this kind of CNV. The outcome of these therapies
was often variable and sometimes disappointing for the stabilization of visual acuity and
lesion size in CNV secondary to AS.
Five patients (six eyes) with CNV secondary to AS participated in this retrospective
interventional case series. All patients were scheduled for three monthly IVB injections
(1.25 mg). Two eyes had been previously treated with photodynamic therapy (PDT), and four
received IVB as first choice treatment. IVB was repeated in case of recurrence after the
three monthly IVB schedule. Ophthalmic evaluations included: best corrected visual acuity
(BCVA) determination (ETDRS), optical coherence tomography (OCT), fluorescein and
indocyanine green angiographies. Main outcome measures were BCVA improvement, reduction of
leakage from CNV and diminution of central retinal thickness (CRT). Patients were
followed-up for 30 months. Patients were 3 males and 2 females aged 44 to 67 years (mean
51.6 +/- 9.07 SD), who received a mean number of 4.33 IB treatments (+/-1.5; min: 3, max:
7). The mean retreatment interval was 3 months (+/-1.36; min: 2, max: 6).
Four eyes (66.6%) showed a BCVA improvement (mean 3.4 lines) from baseline and two eyes
(33.3%) did not show any change in visual acuity from baseline to last follow-up. Mean BCVA
rose significantly from 22.5+/-14.4 letters at baseline to 35.8+/-21.5 letters at 30 months
(p=0.025). Angiographic examinations showed reduction or cessation of the CNV leakage in all
patients. OCT findings demonstrated slight CRT diminution (mean 41.6 µm). No intraocular
pressure changes were observed after the IVB injection, which did not cause any systemic
complication. No injection related back pain or IVB-induced ocular complication was
reported.
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Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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