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Purpose: To evaluate the efficacy and adverse effects of using low-dose intravitreal triamcinolone acetonide (IVTA) to preserve vision in polypoidal choroidal vasculopathy (PCV) eyes., Methods: This retrospective chart review study examined 8 eyes of 7 PCV patients, for whom verteporfin photodynamic therapy (vPDT) or antivascular endothelial growth factor (VEGF) therapy was not affordable/available and also with intolerable risk because of underlying cardiovascular and/or cerebrovascular ischemia. Low-dose IVTA (1 mg/0.025 mL) monotherapy was administered and repeated every 4 weeks if intraretinal edema or subretinal fluid persisted., Results: The median follow-up time was 26.4 months. Three eyes (3/8) maintained their initial best-corrected visual acuity and 4 eyes (4/8) exhibited improvement, whereas 1 eye (1/8) sustained some loss. The mean injection number per month was 0.7 for the first 6 months, after which it decreased to 0.4. In regard to adverse effects, intraocular pressure (IOP) of more than 21 mmHg was noted as persisting for a few weeks in 4 eyes and that of more than 30 mmHg was noted once in 1 eye. The increased IOP was adequately controlled by using IOP-lowering agents. Two initially phakic eyes each underwent cataract surgery in the 12th and 14th months after treatment., Conclusions: Low-dose IVTA therapy may be valuable for preserving the vision of PCV patients, while vPDT or anti-VEGF is not affordable/available or of those with underlying diseases for whom anti-VEGF therapy is with intolerable risk.

The aim of this study was to report the successful treatment of choroidal neovascularization (CNV) in pathologic myopia (PM) with a posterior sub-Tenon bevacizumab (PSTB; Avastin(®)) injection. The study was a prospective case series including nine eyes of eight patients with PM and CNV. All nine eyes were injected with PSTB (12.5 mg/0.5 ml). Treatment effectiveness was evaluated with optical coherence tomography (OCT). If intraretinal edema or subretinal fluid were detected, injections were repeated after 2 weeks. The main outcome measures were logMAR best-corrected visual acuity (BCVA) and central foveal thickness. The mean follow-up time was 77.56 weeks. BCVA improved by a mean of -0.38 logMAR (>3 lines). The average reduction in absolute central foveal thickness was 25.67 μm. OCT revealed marked CNV volume reduction and fluid-free status in seven eyes. The fluid-free status remained for ≥ 1 year in these eyes. Fluorescein angiography revealed CNV resolution in three eyes. Corneal stromal penetration of subconjunctival bevacizumab has been demonstrated in animal studies. PSTB may be an equally effective, yet less invasive alternative for the treatment of myopic CNV.

Purpose: Bevacizumab is a potent recombinant humanized monoclonal antibody directed against vascular endothelial growth factor (VEGF). The purpose of this study was to evaluate the therapeutic effect of subconjunctival injection of bevacizumab on corneal neovascularization (NV) in different rabbit models., Methods: Several rabbit models of corneal NV were used, including (1) a corneal micropocket assay with VEGF pellet, (2) a corneal micropocket assay with basic fibroblast growth factor (b-FGF) pellets, (3) mechanical limbal injury-induced corneal NV, and (4) an alkali-induced model of corneal NV. Subconjunctival injections of bevacizumab (0.25-2.5 mg) were applied twice per week for 2 to 8 weeks. Digital photographs of the cornea were analyzed to determine the length of corneal NV and the area of cornea covered by NV as a percentage of the total corneal area. Immunohistochemical staining with anti-human IgG antibody labeled with Cy3 was used to determine the detection of intracorneal distribution of bevacizumab after injection., Results: Subconjunctival injection of bevacizumab caused significant inhibition of corneal NV formation as measured by length or surface area in all animal models (P<0.05). No significant ocular complications were found. Staining of bevacizumab was found in the corneal stroma for 3 to at least 14 days in the different rabbit models., Conclusions: Subconjunctival injection of bevacizumab is effective in inhibiting corneal NV in several rabbit models. Bevacizumab may diffuse into the corneal stroma and persist for a few days after injection. It may be useful in preventing corneal NV in the acute phase of various kinds of corneal inflammation.