Role of avastin in management of central serous chorioretinopathy

To evaluate the short-term safety and efficacy of intravitreal bevacizumab for the treatment of intraretinal or subretinal fluid accumulation secondary to central serous chorioretinopathy [CSC]. Prospective interventional series non-comparative study. Department of Ophthalmology, Al-Minya University Faculty of Medicine, Egypt. The study included 20 eyes of 20 patients with central serous chorioretinopathy [CSC], Out of them 10 eyes with acute CSC [group I], 6 eyes with chronic CSC [defined as symptoms present for longer than 6 months] and four eyes with recurrent [defined as more than one episode of the disease] chronic and recurrent cases are considered in one group [group II], all patients were injected with intravitreal Avastin [IVA] 1.25 mg [0.05 mL] of commercially available bevacizumab [Avastin; Genentech, Inc., San Francisco, CA] as a primary treatment. At baseline and follow up visits patients had best corrected visual acuity [BCVA], IOP assessment, dilated fundus examination, fundus photography, fluorescein angiography [FA] and optical coherence tomography [OCT] imaging is used for measurement of central retinal thickness [CRT]. Main outcome measures were the resolution of neurosensory detachment, improvement in visual symptoms and visual acuity, and resolution of leakage in FA. Secondary outcome and measures were the need for re-injection and the adverse effects. The mean number of injections was 2 [range 1-3 injections] 6-8 weeks intervals and follow up for 6 months [range 5-7 months]. All finding at baseline and each follow up visit were reported and compared. The mean age of all patients was 40.3 years +/- 6.5 [range 25-50 years], 15 males and five females patients. In acute CSC group, the mean baseline BCVA was 20/60 [log MAR 0.48] and improved to 20/30 [log MAR 0.18] with statistically significance difference change [P<0.003] and in [chronic and recurrent group], the mean baseline VA was 20/80 [log MAR 0.60] and improved to 20/40 [log MAR 0.30] with statistically significance difference change [P<0.002]. The mean baseline CRT for all patients was 486 +/- 86 micro m [range, 386-580], decreased to 316 +/- 56 micro m [range, 276-368] after 1 months with statistically significance difference change [P<0.02] and to 272 +/- 52 micro m [range 220-338] at last follow up with statistically significance difference change from the baseline [P<0.001]. Intravitreal Avastin [IVA] injection was associated with visual improvement and reduced neurosensory detachment without adverse events in patients with CSC. Although these results are promising, further randomized controlled studies would be helpful to understand this therapy for patients with CSC

Early avastin management in acute retinal vein occlusion

To evaluate the safety, functional and anatomical effects of intravitreal Avastin [bevacizumab] in treatment of recent retinal venous occlusion. Prospective interventional series non-comparative study. Department of Ophthalmology, Faculty of Medicine, El-Minia University, Egypt. The study included 30 eyes of 30 patients with recent retinal venous occlusion of less than 3 months duration 12 eyes [40%] of patients with central retinal vein occlusion [CRVO] and 18 eyes [60%] with branch retinal vein occlusion [BRVO] were injected with intravitreal bevacizumab 1.25 mg [0.05 ml] of commercially available bevacizumab [Avastin; Genentech, Inc., San Francisco, CA] at a concentration of 25 mg/ml as a primary treatment. The mean number of injections was 2.7 [range, 1-6 injections] 6-8 weeks intervals and follow-up for 12 months [range, 913 months]. Patients underwent visual acuity testing [VA] as functional assessment. Anatomically, optical coherence tomography [OCT] is used for measurement of central retinal thickness [CRT] to detect macular edema [ME], fundus photography and fluorescein angiography [FA] to detect venous tortuosity, optic disc edema and surface wrinkling rather than ME. All finding at baseline and each follow-up visit were reported. The mean age of all patients was 65.3 years +/- 8.5 [range, 55-82 years], 20 males and 10 females patients. The mean baseline VA was 20/240 [log MAR 1.08 +/- 0.52] and improved to 20/60 [log MAR 0.48 +/- 0.32] with statistically significance difference change [P<0.001]. The mean baseline CRT was 455 micro m +/- 126 [range, 386510], decreased to 356 micro m +/- 118 [range, 296-416] after 1 month with statistically significance difference change [P<0.02] and to 402 micro m +/- 170 [range, 338-468] after 6 months [P<0.067] and to 250 micro m +/- 48 [range, 200298] at last follow-up with statistically significance difference change from the baseline [P<0.001]. There were great proportional decrease in venous tortuosity, optic disc edema and surface wrinkling after 1 month of injection. Neither systemic nor intraocular adverse events were reported. Intravitreal Avastin [IVA] is safe well tolerated, effectively improve VA, fundus picture and stabilize anterior segment neo-vascular activity in patients with recent retinal venous occlusion