[Intravitreal ranibizumab injections for the treatment of choroidal neovascularization complicating high myopia]. / Néovaisseaux choroïdiens du myope fort: traitement par injection intravitréenne de ranibizumab.

INTRODUCTION: Macular choroidal neovascularization (CNV) is a serious complication of high myopia, compromising the visual prognosis in young patients. The purpose of this study was to evaluate the safety and efficacy of first-line intravitreal ranibizumab in the treatment of myopic CNV. PATIENTS AND METHODS: We conducted a single-center prospective, consecutive, interventional study of patients with subfoveal or juxtafoveal CNV secondary to pathologic myopia (PM) treated with intravitreal injection of ranibizumab in the Beni-Messous University Hospital from January 2009 to April 2010. Best-corrected visual acuity (BCVA), fundus examination, optical coherence tomography (OCT), and fluorescein angiography (FA) were performed at baseline and monthly for all patients. Indications for retreatment were persistence or recurrence of the neovascular activity. RESULTS: The study included 40 eyes of 40 patients, 33 of whom were females (82.5%), with a mean age of 40.22 ± 10.81 years (range, 20-55 years), with visual acuity between 1/100 and 1/10. The mean spherical equivalent refractive error was -14.13 ± 4.65 diopters (range, -7 D to -23 D). The mean follow-up time was 8 months (range, 3-15 months). The mean number of intravitreal injections administered for each patient was 2.2 (range: 1-4). Follow-up ranged from 3 to 15 months (mean, 8 months). All patients maintained or improved their vision; the average gain in visual acuity was three lines (range: 1-9 lines). No injection complications or drug-related side effects were noted during the follow-up period. DISCUSSION: Intravitreal ranibizumab to treat CNV complicated by high myopia seems to be associated with an improvement in VA and good tolerance. This study confirms the efficacy of first-line anti-VEGF, in particular, ranibizumab in this indication. CONCLUSION: In this series of eyes with limited follow-up, intravitreal ranibizumab was a safe and effective treatment for CNV secondary to PM, resulting in functional and anatomic improvement.

[Intravitreal bevacizumab in the treatment of neovascular glaucoma]. / Injection intravitréenne de Bevacizumab (Avastin) dans le traitement du glaucome néovasculaire.

PURPOSE: To report the effect of an intravitreal injection of 1.25 mg (0.05 ml) of bevacizumab (IVB) as symptomatic treatment for neovascular glaucoma. PATIENTS AND METHOD: This prospective study included 13 eyes of 12 patients presenting neovascular glaucoma, in two cases secondary to ischemic central retinal vein occlusion and, in ten cases, to proliferative diabetic retinopathy. Each patient received an intravitreal injection of 1.25 mg (0.05 ml) of bevacizumab, in combination with other procedures such as panretinal photocoagulation to treat retinal ischemia and transscleral cyclocryoapplication as glaucoma treatment. Their mean age was 58 years (range, 35-75 years). The mean intraocular pressure (IOP) was 40 mmHg+/-10 mmHg. The mean follow-up was 6 months. RESULTS: IVB resulted in a marked regression of anterior segment neovascularization and relief of symptoms within 48 h. IOP decreased substantially in eight eyes; in four eyes, adjuvant cyclocryoapplication was necessary. The last eye was affected by a retinal detachment 1 month after IVB. No side effects were observed. DISCUSSION: We observed that the intravitreal injection of bevacizumab enabled the total regression of iris and angle neovascularization but had only a partial action on intraocular hypertension. CONCLUSION: Intravitreal injection of 1.25 mg (0.05 ml) of bevacizumab contributes to a better management of neovascular glaucoma.