INTRAVITREAL BEVACIZUMAB IN VASCULAR PIGMENT EPITHELIUM DETACHMENT AS A RESULT OF SUBFOVEAL OCCULT CHOROIDAL NEOVASCULARIZATION IN AGE-RELATED MACULAR DEGENERATION

Purpose: The purpose of this study was to evaluate the effect of intravitreally administered bevacizumab on untreated vascularized pigment epithelium detachment (PED) in sub-or juxtafoveal occult choroidal neovascularization as a result of age-related macular degeneration. Methods: In this retrospective study, 28 untreated eyes of 26 patients (4 men, 22 women; mean age, 74.6 +/- 7.2 years) with PED and sub-or juxtafoveal occult choroidal neovascularization as a result of age-related macular degeneration and additional intra- and/or subretinal fluid were treated with intravitreal injections of 1.25 mg bevacizumab. Baseline and follow-up visits included best-corrected visual acuity, complete ophthalmic examination, and Stratus optical coherence tomography. Fluorescein angiography was performed at baseline. Reinjections were performed if intra- and/or subretinal fluid persisted or recurred or PED increased. Results: Patients received 3.2 +/- 1.8 injections (follow-up 37.9 +/- 18.3 weeks). Mean maximum PED height showed a tendency to decrease (372 +/- 150.5 mu m to 290.3 +/- 189 mu m; P = 0.094). In 14 eyes (53.8%), PED height was reduced at last visit, including complete flattening in 1 eye. Mean visual acuity remained stable (0.58 +/- 0.30 logarithm of the minimum angle of resolution to 0.58 +/- 0.37 logarithm of the minimum angle of resolution; P = 0.905). Pigment epithelium detachment response to treatment did not correlate with baseline PED height or visual acuity at baseline or at the last visit. One patient sustained a retinal pigment epithelium rip, and another patient sustained an extensive subretinal hemorrhage. Conclusion: During bevacizumab therapy, mean PED height decreases in 50% of patients. No predictive factors for the response of PED to bevacizumab treatment could be identified. Treatment of PED with bevacizumab might result in a long-term functional benefit compared with the natural course. RETINA 30: 1420-1425, 2010