Intravitreal bevacizumab (avastin) in a pediatric case of pathologic myopia

To report the successful consecutive use of intravitreal bevacizumab (Avastin) in a child with myopic choroidal neovascular membrane (mCNVM).

A 12-year-old child presented with gradual diminution of vision in both eyes. Ocular examination revealed pathologic myopia with mCNVMs in both eyes. Leakage was demonstrated on fluorescein angiography in right eye at the first visit, followed by the left eye 1 week later. A single injection of bevacizumab (Avastin) 1.25 mg (0.05 mL) was administered under aseptic precautions using a 30-G needle in each eye separated by duration of 1 week. There were no complications during or after each procedure

: Leakage from the mCNVM was reduced in both eyes within 2 weeks after the injections and there was reduction of macular thickness in both eyes. However, visual acuity change was modest, with the right eye improving from Snellen acuity of 1/60 before injection to 6/60 and the left eye remaining stable at 3/60.

Intravitreal Avastin was safely injected successively in each eye in a pediatric case of pathologic myopia with mCNVM. Reduction of leakage and macular thickening may not be associated with commensurate visual improvement as in our case. Long-term safety and appropriate dosage of intravitreal bevacizumab needs to be studied before routine use in pediatric cases of neovascularization.