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Intravitreal bevacizumab (avastin) in a pediatric case of pathologic myopia
Natarajan Sundaram1, Mahesh Uparkar, Ashish Athale
1From *Aditya Jyot Research Foundation and †Aditya Jyot Eye Hospital, Mumbai, India.
Insights
Intravitreal bevacizumab (Avastin) was safely used in a child with myopic choroidal neovascularization (mCNVM). While it reduced leakage and macular thickness, visual acuity improvement was modest, highlighting the need for further pediatric studies.
Area of Science:
- Ophthalmology
- Medical Research
Background:
- Pathologic myopia can lead to myopic choroidal neovascularization (mCNVM).
- mCNVM can cause vision loss in pediatric patients.
Purpose of the Study:
- To document the consecutive intravitreal use of bevacizumab (Avastin) in a pediatric patient with mCNVM.
- To assess the safety and efficacy of bevacizumab in this context.
Main Methods:
- A 12-year-old child with mCNVM in both eyes received sequential intravitreal bevacizumab injections (1.25 mg per eye).
- Injections were administered one week apart under aseptic conditions.
- No immediate complications occurred during or after the procedures.
Main Results:
- Reduced leakage from mCNVM and decreased macular thickness were observed in both eyes within two weeks post-injection.
- Visual acuity showed modest improvement in one eye and remained stable in the other.
Conclusions:
- Consecutive intravitreal bevacizumab injections were safely administered to a pediatric patient with pathologic myopia and mCNVM.
- Reduced leakage and macular thickening did not directly correlate with significant visual acuity gains.
- Further research on long-term safety and optimal dosage of intravitreal bevacizumab is necessary for pediatric neovascularization cases.
Purpose:
To report the successful consecutive use of intravitreal bevacizumab (Avastin) in a child with myopic choroidal neovascular membrane (mCNVM).
Method:
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
Results:
: 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.
Conclusion:
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.
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