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Purpose: To evaluate ocular function and systemic development in premature infants treated with intravitreal bevacizumab injections for retinopathy of prematurity over a period of 5 years., Methods: A prospective, interventional, noncomparative case study. The primary outcome measure was visual acuity. The secondary outcomes were structural assessment, other ocular functional measurements, and developmental state., Results: Eighteen eyes of 13 consecutive patients were divided into 3 groups: Group 1, Stage 4 unresponsive to previous conventional treatment (n = 4); Group 2, in which conventional treatment was difficult or impossible because of inadequate visualization of the retina (n = 5); and Group 3, newly diagnosed high-risk prethreshold or threshold retinopathy of prematurity (n = 9). All patients showed initial regression of neovascularization. One patient was diagnosed with recurrence of neovascularization and was treated with intravitreal bevacizumab. Visual acuity was preserved, and median vision was 20/25 (excluding 2 operated eyes). Twelve eyes developed mainly low myopia over the years, with an overall mean value of 3.2 diopters. Electroretinograph was normal in 4 eyes that had no previous detachment. One patient showed delay in growth and neurodevelopment, whereas all the others were within the normal range., Conclusion: Five years of follow-up in a small series suggest that intravitreal bevacizumab for retinopathy of prematurity results in apparently preserved ocular function and systemic development.

Background: The International Clinical Diabetic Macular Edema Disease Severity Scale grades retinal thickening according to its distance from the macular center, but its definitions have not been standardized quantitatively. We undertook this study to identify the severity distribution of diabetic macular edema at the time of diagnosis. We used optical coherence tomography (OCT) in a standardized manner and identified the proportion of eyes that required immediate treatment., Methods: We carried out an observational, prospective, cross-sectional, descriptive study. Diabetic patients with a diagnosis of clinically significant macular edema were evaluated. Severity levels according to the International Clinical Scale were operatively defined, guided by the thickening location in a 6-mm OCT fast macular map, as mild (thickening outside the 3-mm circle), moderate (thickening outside the 1-mm circle), and severe (thickening within the 1-mm circle). The proportion and 95% confidence intervals (CI) were identified for each severity level., Results: We studied 118 eyes (mean ± SD: 59.9 ± 8.3 years). Seventy one eyes had nonproliferative retinopathy (60.1%), 94 eyes (79.7%) had focal macular edema, and 24 eyes (20.3%) showed diffuse edema. Edema severity was mild in 27 eyes (22.9%, 95% CI 15.3-30.5), moderate in 23 (19.5%, 95% CI 12.3-26.6) and severe in 68 (57.6% 95% CI 48.7-66.5)., Conclusions: Standardization of the International Clinical Scale using OCT showed that the most common severity level of macular edema was severe; the minimum expected proportion of eyes with high risk of visual loss secondary to severe edema approached 50%. Opportune detection needs reinforcement because more than half of these eyes require immediate treatment.

Purpose: To determine short-term effects of intravitreal bevacizumab for subfoveal choroidal neovascularization (CNV) in pathologic myopia., Methods: In this prospective interventional case series, patients were treated with 2.5 mg of intravitreal bevacizumab and followed for 3 months. Best-corrected visual acuity (BCVA), optical coherence tomography (OCT), and fluorescein angiography (FA) were recorded. Indications for retreatment were active leaking CNV shown by FA and presence of subretinal fluid by OCT in combination with visual disturbances., Results: Fourteen patients were included, with a mean age of 53.86 +/- 16.26 years (range 29-85). Mean spherical equivalent was -13.87 +/- 3.68 diopters (-7.25 to -20.50). Minimum follow-up was 3 months. There were no adverse events. The mean initial visual acuity was 20/200 improving to 20/100 at 2 weeks, 20/80 at 4 weeks, and 20/60 at 8 and 12 weeks (P=0.007; P=0.001; P=0.005; P=0.001, respectively). Initial foveal thickness improved from 385.43 microm +/- 125.83 microm to 257.64 +/- 76.6 microm and 194.54 +/- 54.35 microm after the first and third month, respectively (P=0.001)., Conclusions: Initial treatment results of patients with CNV due to pathologic myopia did not reveal any short-term safety concerns. Intravitreal bevacizumab resulted in a significant decrease in foveal thickness and improvement in visual acuity. These favorable initial results support further larger and long-term studies.