Abstract

P 283

Intravitreal bevacizumab for extrafoveal choroidal neovascularization secondary to a choroidal nevus

Dorothee Möller, Rainer Guthoff
Universitäts-Augenklinik Würzburg

Objective
Choroidal neovascularization (CNV) secondary to a choroidal nevus (CN) is a rare (0,9-1%) complication. The natural history of this disease is characterized by a stable median visual acuity (VA) of 0,8 (range: initially 0,1-1,33, finally light perception-1,0) after a median follow-up time of 4 years. In small case series improvement of median VA from 0,4 (range 0,05-1,0) to 0,8 (0,4-1,0) after laser photocoagulation of the CNV after a mean of 1,4 years is reported. Verteporfin-photodynamic therapy (PDT) showed a median VA increase from 0,11 (range 0,05-0,17) to 0,45 (0,4-0,5) after median follow-up period of 0,7 years.
However, a lack of response can be expected of laser photocoagulation or PDT in a considerable neurosensory detachment. We report on a case of a CNV with serous detachment secondary to CN treated intravitreal bevacizumab.
Methods
An otherwise healthy 29-year old male patient presented with decreased VA of 0.9 and metamorphopsia of the right eye. Posterior segment examination revealed a pigmented CN superior to the macula with neurosensory detachment extending to the fovea. Fluorescein angiogram demonstrated an increasing extrafoveal hyperfluorescent leakage overlying the choroidal nevus consistent with a secondary choroidal neovascularization. After informed consent 3 intravitreal bevacizumab injections (1,5mg) were performed in 8-weekly intervals.
Results
Three months after the last bevacizumab injection VA improved to 1.25 with complete resolvement of metamorphopsia, and the neovascular membrane regressed with minimal subretinal fluid and leakage.
Conclusions
Intravitreal bevacizumab treatment for extrafoveal choroidal neovascularization secondary to a choroidal nevus appears to be an effective and safe procedure on short follow-up term.

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