Intravitreal Bevacizumab for Treatment of Choroidal Neovascularization Secondary to Toxoplasmic Retinochoroiditis: A Case Series

Abstract

Purpose: To evaluate the efficacy and safety of intravitreal bevacizumab (Avastin) in treatment of choroidal neovascularization (CNV) secondary to toxoplasmic retinochoroiditis. Design: Prospective case series. Methods: Four patients affected by CNV secondary to inactive toxoplasmic retinochoroiditis received 1.25mg intravitreal bevacizumab and were followed for at least six months. Patients underwent a full ophthalmic examination and fluorescein angiography (FA) and optical coherence tomography (OCT), revealing an active subfoveal CNV close to an old chorioretinal scar. All the patients were positive for toxoplasma immunoglobulins. Outcome measures were changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT) and any adverse event related to the therapy. Results: CNV regressed at eight weeks of follow-up and remained stable at six months of follow-up. Best-corrected visual acuity improved from mean 0.05 to 0.25. After six months, the BCVA improved in all patients (p<0.05) and CMT decreased from 396 +/-7 micron to 253+/-17 micron. Metamorphopsia was resolved in all cases. Conclusions: Intravitreal bevacizumab seems to be an effective treatment for the long-term control of juxta/subfoveal CNV secondary to toxoplasmic retinochoroiditis. Further trials are mandatory to validate the data of our case series.