Intravitreal Bevacizumab for Non-Subfoveal Choroidal Neovascularization Associated with Angioid Streaks – Accepted Manuscript

Abstract: Purpose: To evaluate the effects of intravitreal bevacizumab injections in the treatment of non-subfoveal choroidal neovascularization (CNV) associated with angioid streaks.Design: Non-randomized, interventional, prospective case series.Methods: Fifteen patients (15 eyes) affected by juxtafoveal or extrafoveal CNV secondary to angioid streaks were enrolled in the study. All patients underwent a complete ophthalmologic examination, including best-corrected visual acuity (BCVA) measurement on Early Treatment Diabetic Retinopathy Study (ETDRS) chart, optical coherence tomography (OCT), and fluorescein angiography (FA). The protocol treatment included a first injection, followed by repeated injections over a 12-month follow-up period on the basis of the detection of new hemorrhage on biomicroscopic examination, any type of fluid on OCT and/or presence of leakage on FA. Primary outcome measures: Mean changes in BCVA and proportion of eyes gaining at least 10 letters (2 ETDRS lines) at the end of the follow-up. Secondary outcomes: Mean changes of central macular thickness (CMT) and extension to the fovea.Results: Mean BCVA did not change throughout the follow-up period, being 0.2±0.2 LogMAR at baseline and 0.2±0.3 LogMAR at the 12-month examination. A functional improvement of at least 2 ETDRS lines was achieved by 5 eyes (33%), with 3 eyes (20%) gaining 3 lines. Mean CMT at baseline was 215±13μm and 225±85μm at the 12-month examination. Two eyes (13.3%) showed CNV extension to the fovea.Conclusions: Intravitreal bevacizumab injection can be a beneficial approach for the management of non-subfoveal CNV secondary to angioid streaks over a one-year follow-up.