Intravitreal bevacizumab for CNV-complicated tilted disk syndrome

Tilted disc syndrome is a congenital anomaly characterized by an inferonasal "tilting" of the optic disc. We report three patients affected by macular neovascularisation-complicated tilted disk syndrome treated by intravitreal bevacizumab.

Three interventional case reports are hereby documented. Ophthalmic evaluations were registered, including monthly visual acuity examination, OCT and fluorescein angiography before and after consecutive intravitreal injection of 1.25 mg bevacizumab (0.05 ml, Avastin).

All patients, aged more than 65 years, experienced decreased visual acuity after an observation period of 6 (two patients) and 3 months (one patient). Angiographic leakage with neuroretinal rarefaction and RPE/choriocapillary complex elevation at OCT remained persistent in two patients and reduced in one.

No benefit in terms of visual acuity was noted after intravitreal bevacizumab treatments. Larger studies should be conducted to confirm our small series observation.