Treatment of peripapillary choroidal neovascularization with intravitreal bevacizumab

Peripapillary choroidal neovascularization (CNV) is an uncommon condition and often shows a growth tendency towards the fovea during spontaneous progression that threatens visual acuity. Treatment of peripapillary CNV is difficult. The authors report results of intravitreal bevacizumab therapy for peripapillary CNV.

Four patients with CNV located in the temporal or superior peripapillary area received intravitreal bevacizumab injections. Ophthalmologic examinations including OCT were performed at baseline and at 6-week intervals. Fluorescein angiography was performed at baseline and depending on clinical and OCT findings. The mean follow-up was 34+/-20 (22-69) weeks.

The patients received an average of 3.5+/-3.1 (1-8) injections. In all patients fluorescein angiography showed inactivation of peripapillary CNV. No further increase in size was observed in any of the patients. The OCT showed a decrease of intraretinal and subretinal fluid. No intraocular or systemic side effects were observed.

In this series of patients, intravitreal bevacizumab appears to be efficacious. A progression of peripapillary CNV could be prevented in all patients and the lesion was successfully inactivated. Anti-VEGF treatment with bevacizumab represents a promising therapy option for peripapillary CNV.