Intravitreal Bevacizumab (Avastin) as Primary Treatment for Myopic Choroidal Neovascularization

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Abstract
Purpose: To evaluate the short-term efficacy and safety of intravitreal bevacizumab in myopic choroidal neovascularization (mCNV). Methods: In this noncomparative, consecutive, interventional case series, 12 eyes of 11 patients with mCNV without any previous treatment were included. Patients received intravitreal bevacizumab (1.25 mg/0.05 mL) at baseline and at 4 weeks interval, if optical coherence tomography (OCT) showed presence of intraretinal edema, subretinal fluid, and/or pigment epithelial detachment. Patients were followed up for a minimum of 6 months and changes in best-corrected visual acuity, central macular thickness (CMT) on OCT, angiographic characteristics, and complications were assessed. Results: The mean refractive error was −11.25 diopters. At 6 months the mean best-corrected visual acuity (BCVA) improved from 20/235 (median 20/235) to 20/71 (median 20/80) (p=0.01). The mean CMT was reduced from 403 μm (median 365 μm) to 229 μm (median 239 μm) (p=0.002). At final visit 9 eyes (75%) had an improvement of BCVA of three lines or more, and only 1 eye (8%) lost two lines. No significant ocular or untoward systemic side effects were observed. Conclusions: In this small series short-term results suggest that intravitreal bevacizumab (1.25 mg/0.05 mL) is safe, effective, and well tolerated in patients with choroidal neovascularization due to high myopia. Further evaluation in large series with longer follow-up is needed to confirm long-term efficacy and safety in such cases.