Skip to main content
SpringerLink
Log in

Intravitreal Bevacizumab bei choroidaler Neovaskularisation infolge pathologischer Myopie

Intravitreal bevacizumab for choroidal neovascularization due to pathological myopia

  • Originalien
  • Published:
Der Ophthalmologe Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

Untersuchung von Sicherheit und Effektivität von intravitrealem Bevacizumab bei choroidaler Neovaskularisation infolge pathologischer Myopie (mCNV).

Methoden

Konsekutive Serie von 23 Patienten mit mCNV behandelt mit 1,25 mg Bevacizumab intravitreal nach ausführlicher Aufklärung über den Off-Label-Charakter. Sechs Patienten erhielten zusätzlich eine einmalige PDT. Nachkontrollen in 6-Wochen-Abständen mit EDTRS-Visus, OCT und befundabhängig Angiographien. Reinjektionen erfolgten alle 6 Wochen bei persistierender sub- bzw. intraretinaler Flüssigkeit.

Ergebnisse

Der Ausgangsvisus betrug 0,25 (0,58 logMAR ± 0,36). Im Mittel wurden 1,4±0,8 Injektionen gegeben bei einem Follow-up von 16,6±13,7 Wochen. Bei allen Patienten kam es zur CNV-Inaktivierung. Der Visus stieg durchschsnittlich um 2,3±3,5 Linien, bei 9 Patienten (39,1%) um ≥3 Linien. Kein Patient verlor mehr als eine Linie. Bei Patienten ohne zusätzliche PDT (n=17) war der mittlere Visusanstieg 2,59±3,9 Linien, bei 7 Patienten (41,2%) ≥3 Linien. Es wurden keine intraokularen oder systemischen Nebenwirkungen beobachtet.

Schlussfolgerung

In dieser bislang größten Fallserie zeigte sich die intravitreale Bevacizumab-Therapie bei mCNV sicher und effektiv. Bei den meisten Patienten bewirkte bereits eine einmalige Bevacizumab-Injektion eine CNV-Inaktivierung.

Abstract

Purpose

The aim of this study was to evaluate the safety and efficacy of intravitreal bevacizumab as a treatment for choroidal neovascularization (mCNV) due to pathological myopia.

Methods

A consecutive series of 23 patients with mCNV treated with 1.25 mg intravitreal bevacizumab after being thoroughly informed about the off-label character of the treatment. Of the patients 6 received additional photodynamic therapy at the time of first injection. Reinjections were given every 6 weeks if intraretinal or subretinal fluid persisted.

Results

The pre-injection mean visual acuity (VA) was 0.25 (0.58 logMAR±0.36). During a follow up of 16.6±13.7 weeks 1.4±0.8 injections were given. Complete resorption of subretinal or intraretinal fluid was achieved in all patients. VA improved by 2.3±3.5 lines on average, 9 patients (39.1%) had an increase of ≥3 lines, none lost more than 1 line. Patients with bevacizumab monotherapy (n=17) had an improvement of 2.59±3.9 lines, 7 patients (41.2%) had an increase of ≥3 lines. No intraocular or systemic side effects were observed.

Conclusions

In this as yet largest series of patients with mCNV treated with intravitreal bevacizumab, the treatment seemed to be effective and safe.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1
Abb. 2

Literatur

  1. Chan WM, Lai TY, Liu DT et al. (2007) Intravitreal bevacizumab (avastin) for myopic choroidal neovascularization. Ophthalmology 114: 2190–2196

    Article  PubMed  Google Scholar 

  2. Degenring RF, Jonas JB (2005) Photodynamic therapy in combination with intravitreal triamcinolone for myopic choroidal neovascularization. Acta Ophthalmol Scand 83: 621

    Article  PubMed  CAS  Google Scholar 

  3. Fung AE, Rosenfeld PJ, Reichel E (2006) The international intravitreal bevacizumab safety survey: using the internet to assess drug safety worldwide. Br J Ophthalmol 90: 1344–1349

    Article  PubMed  CAS  Google Scholar 

  4. Hernandez-Rojas ML, Quiroz-Mercado H, Dalma-Weiszhausz et al (2007) Short-term effects of intravitreal bevacizumab for subfoveal choroidal neovascularization in pathologic myopia. Retina 27: 707–712

    PubMed  Google Scholar 

  5. Laud K, Spaide RF, Freund KB et al (2006) Treatment of choroidal neovascularization in pathologic myopia with intravitreal bevacizumab. Retina 26: 960–963

    Article  PubMed  Google Scholar 

  6. Mandal S, Venkatesh P, Sampangi R, Garg S (2007) Intravitreal bevacizumab (avastin) as primary treatment for myopic choroidal neovascularization. Eur J Ophthalmol 17: 620–626

    PubMed  CAS  Google Scholar 

  7. Nguyen QD, Shah S, Tatlipinar S et al (2005) Bevacizumab supresses choroidal neovascularization caused by pathological myopia. Br J Ophthalmol 89: 1368–1370

    Article  PubMed  CAS  Google Scholar 

  8. Potter MJ, Szabo SM, Ho T (2005) Combined photodynamic therapy and intravitreal triamcinolone for the treatment of myopic choroidal neovascularization in a 13-year old girl. Graefe‘s Arch Clin Exp Ophthalmol 21: 1–3

    Google Scholar 

  9. Rosenfeld PJ (2006) Intravitreal avastin for choroidal neovascularisation in pathological myopia: the controversy continues. Br J Ophthalmol 91: 128–130

    Article  Google Scholar 

  10. Sagaguchi H, Ikuno Y, Gomi F et al (2007) Intravitreal injection of bevacizumab for choroidal neovascularisation associated with pathological myopia. Br J Ophthalmol 91: 161–165

    Article  Google Scholar 

  11. Secretan M, Kuhn D, Soubrane G, Coscas G (1997) Long-term visual outcome of choroidal neovascularization in pathologic myopia: natural history and laser treatment. Eur J Ophthalmol 7: 307–316

    PubMed  CAS  Google Scholar 

  12. Schaal KB, Höh AE, Scheuerle A et al (2007) Bevacizumab zur Therapie des Makulaödems infolge venöser retinaler Gefäßverschlüsse. Ophthalmologe 104: 285–289

    Article  PubMed  CAS  Google Scholar 

  13. Tewari A. Dhalla MS, Apte RS (2006) Intravitreal bevacizumab for treatment of choroidal neovascularization in pathologic myopia. Retina 26: 1093–1094

    Article  PubMed  Google Scholar 

  14. Verteporfin in Photodynamic Therapy (VIP) Study Group (2001) Photodynamic therapy of subfoveal choroidal neovascularization in pathologic myopia with verteporfin: 1-year results of a rondomized clinical trial – VIP report No 1. Ophthalmology 108: 841–852

    Article  Google Scholar 

  15. Verteporfin in Photodynamic Therapy (VIP) Study Group (2003) Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia. VIP report No 3. Ophthalmology 110: 667–673

    Article  Google Scholar 

  16. Xu L, Wang Y, Li Y et al (2006) Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study. Ophthalmology 113: 1–3

    Article  Google Scholar 

  17. Yamamoto I, Rogers AH, Reichel E et al (2007) Intravitreal bevacizumab (Avastin) as treatment for subfoveal choroidal neovascularisation secondary to pathological myopia. Br J Ophthalmol 91: 157–160

    Article  PubMed  Google Scholar 

  18. Yoshida T, Ohno-Matsui K, Ohtake Y et al (2002) Long-term visual prognosis of choroidal neovascularization in high-myopia: a comparison between age groups. Ophthalmology 109: 712–719

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Leiter Schwerpunkt Retinologie Universitäts-Augenklinik, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    S. Dithmar, K.B. Schaal, A.E. Höh, S. Schmidt & F. Schütt

Authors
  1. S. Dithmar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. K.B. Schaal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A.E. Höh
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. Schütt
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

Der Vortrag wurde auf der 105. Jahrestagung der DOG gehalten.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dithmar, S., Schaal, K., Höh, A. et al. Intravitreal Bevacizumab bei choroidaler Neovaskularisation infolge pathologischer Myopie. Ophthalmologe 106, 527–530 (2009). https://doi.org/10.1007/s00347-008-1806-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00347-008-1806-z

Schlüsselwörter

Keywords

Search

Navigation