Intravitreal Bevacizumab in Agioid Streaks
Condition: Angioid Streaks; Choroidal Neovascularization
MeSH terms: Choroidal Neovascularization; Angioid Streaks; Neovascularization, Pathologic
Study type: Interventional
Phase: Phase 1

Summary: 
      The purpose of this study is to investigate the safety and efficacy of intravitreal
      bevacizumab in patients with choroidal neovascularization associated with angioid streaks.
    

Detailed description: 
      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.
    

Intervention name(s): intravitreal injection; intravitreal injection
Intervention type(s): Drug; Drug
Intervention description(s): 1.25 mg in 0.05 cc of bevacizumab; 1.25 mg of bevacizumab intravitreally injected in a steril field
Other intervention name(s): intravitreal bevacizumab; intravitreal bevacizumab
Intervention MeSH terms: Bevacizumab
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment