Indian Journal of Ophthalmology

BRIEF COMMUNICATION
Year
: 2010  |  Volume : 58  |  Issue : 2  |  Page : 160--162

Intravitreal bevacizumab for choroidal neovascular membrane associated with Best's vitelliform dystrophy


Ekta Rishi, Pukhraj Rishi, Sheshadri Mahajan 
 Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18, College Road, Chennai - 600 006, India

Correspondence Address:
Pukhraj Rishi
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18, College Road, Chennai - 600 006
India

Abstract

Best�SQ�s vitelliform macular dystrophy is a hereditary form of progressive macular dystrophy that can be complicated by choroidal neovascularization. Authors report successful treatment of choroidal neovascularization with intravitreal bevacizumab in one such eye in an �SQ�adult�SQ� Indian male with visual improvement. A 23-year-old male presented with diminution of vision in the right eye for the past sixteen months. Visual acuity was 20/400 in the that eye. After three consecutive intravitreal injections of bevacizumab (1.25 mg/0.05 ml), vision improved to 20/120. Seven months following the last injection of bevacizumab, fundus appeared stable and visual acuity was maintained. No drug-related ocular or systemic side effects were encountered. To the best of our knowledge (PubMed search), this is the first report of its kind in an adult Indian patient. Intravitreal bevacizumab appears to be a promising and cost-effective modality of treatment in such eyes with potential for improvement in vision. However, a long-term follow-up is warranted.



How to cite this article:
Rishi E, Rishi P, Mahajan S. Intravitreal bevacizumab for choroidal neovascular membrane associated with Best's vitelliform dystrophy.Indian J Ophthalmol 2010;58:160-162


How to cite this URL:
Rishi E, Rishi P, Mahajan S. Intravitreal bevacizumab for choroidal neovascular membrane associated with Best's vitelliform dystrophy. Indian J Ophthalmol [serial online] 2010 [cited 2024 Mar 28 ];58:160-162
Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?2010/58/2/160/60096


Full Text

Best's disease, also known as Best's vitelliform macular dystrophy, is a hereditary form of progressive macular dystrophy that can be complicated by choroidal neovascularization. [1] Andrade et al. have reported regression of choroidal neovascularization, resolution of exudative manifestations and significant visual improvement following a single treatment session of photodynamic therapy (PDT). [2] However, PDT may not always be an affordable treatment option in the developing world. Bevacizumab, an anti-vascular endothelial growth factor (VEGF), is a humanized, monoclonal antibody being commonly used as an 'off-label' drug for the management of choroidal neovascularization due to age related macular degeneration, [3] pathological myopia, [4] idiopathic parafoveal telengiectasia [5] and angioid streaks. [6] Recently, there has been a report of treatment of choroidal neovascularization related to Best's disease in a thirteen-year-old child with a single injection of intravitreal bevacizumab. [7] We hereby report a case of successful treatment of choroidal neovascularization with intravitreal bevacizumab in one such eye in a young adult Indian male associated with visual improvement. To the best of our knowledge (PubMed search), this is the first report of its kind.

 Case Report



A 23-year-old male presented with a history of diminution and distortion of vision in the right eye for the past 16 months. His best corrected visual acuity (BCVA) was 20/400; et al. [7] in a 13-year-old boy, albeit in an adult Indian patient with three injections. We also feel that had the treatment been initiated at a more acute stage, the outcome would have been better. Intravitreal bevacizumab appears to be a promising, cost-effective modality of treatment with a potential for improvement in visual acuity, although with inherent risks associated with intravitreal injections. A long-term follow-up is warranted to address possible recurrences and determine the optimal number of re-treatments required in achieving a long-term stabilization of the aforesaid condition.

References

1Miller SA, Bresnick GH, Chandra SR. Choroidal neovascular membrane in Best's vitelliform macular dystrophy. Am J Ophthalmol 1976;82:252-5.
2Andrade RE, Farah ME, Costa RA. Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization in Best's disease. Am J Ophthalmol 2003;136:1179-81.
3Yoganathan P, Deramo VA, Lai JC, Tibrewala RK, Fastenberg DM. Visual improvement following intravitreal bevacizumab (Avastin) in exudative age-related macular degeneration. Retina 2006;26:994-8.
4Tewari A, Dhalla MS, Apte RS. Intravitreal bevacizumab for treatment of choroidal neovascularization in pathologic myopia. Retina 2006;26:1093-4.
5Jorge R, Costa RA, Calucci D, Scott IU. Intravitreal bevacizumab (Avastin) associated with the regression of subretinal neovascularization in idiopathic juxtafoveolar retinal telangiectasis. Graefes Arch Clin Exp Ophthalmol 2007;245:1045-8.
6Teixeira A, Moraes N, Farah ME, Bonomo PP. Choroidal neovascularization treated with intravitreal injection of bevacizumab (Avastin) in angioid streaks. Acta Ophthalmol Scand 2006;84:835-6.
7Leu J, Schrage NF, Degenring RF. Choroidal Neovascularisation secondary to Best's disease in a 13-year-old boy treated by intravitreal bevacizumab. Graefe's Arch Clin Exp Ophthalmol 2007;245:1723-5.