Long-term Visual Outcomes of Intravitreal Bevacizumab in Inflammatory Ocular Neovascularization

PURPOSE: To assess the long,term role of bevacizumab (Avastin; Genentech Inc, South San Francisco, California, USA) in inflammatory ocular neovascularization. DESIGN: Retrospective multicenter consecutive case series of inflammatory ocular neovascularization. METHODS: SETTINGS: Multicenter institutional and private practices. STUDY POPULATION: Patients with inflammatory ocular neovascularization in one or both eyes of varying etiologies who failed standard therapy. INTERVENTION: Intravitreal injection of bevacizumab. MAIN OUTCOME MEASURES: Improvement of best-corrected visual acuity (BCVA) expressed as logarithm of minimal angle of resolution (logMAR), and decrease in central foveal thickness as measured by optical coherence tomography at 6, 12, 18, and 24 months of follow-up. 0 RESULTS: Mean logMAR BCVA (central foveal thickness) following intravitreal bevacizumab was as follows: baseline, 0.65 (6/27 or 20/90) (338 mu m; 99 eyes of 96 patients); 6 months, 0.42 (6/16 or 20/53) (239 mu m; 2.0 injections; 81 eyes); 12 months, 0.39 (6/15 or 20/49) (241 mu m; 2.3 injections; 95 eyes); 18 months, 0.40 (6/15 or 20/50) (261 mu m; 3.0 injections; 46 eyes); and 24 months, 0.34 (6/13 or 20/44) (265 mu m; 3.6 injections; 27 eyes). Paired comparisons revealed significant visual improvement at 6 months of 2.4 lines (P =.000), at 12 months of 2.5 lines (P = .000), at 18 months of 2.5 lines (P =.001), and at 24 months of 2.2 lines (P =.013). Paired comparisons revealed significant central foveal flattening at 6 months of 78 mu m (P =.000), at 12 months of 85 mu m (P =.000), at 18 months of 90 mu m (P =.003), and at 24 months of 77 mu m (P =.022). Three eyes developed submacular fibrosis and 1 eye submacular hemorrhage. CONCLUSION: Intravitreal bevacizumab led in the long-term to significant mean visual improvement of >= 2.2 lines and significant foveal flattening in a wide variety of inflammatory ocular diseases without major complications. (Am J Ophthalmol 2009;148:310-316. (C) 2009 by Elsevier Inc. All rights reserved.)