Intravitreal Avastin shows promise for serous pigment epithelial detachment

RIO GRANDE, Puerto Rico — Intravitreal bevacizumab may improve and stabilize vision in patients with serous pigment epithelial detachment, said one speaker here.

Ayala Pollack, MD, analyzed data from 17 eyes of 17 patients who underwent an intravitreal injection of Avastin (bevacizumab, Genentech) in an IRB-approved, open-label, uncontrolled study in Israel. Patients had to fail other therapies before enrollment in this trial, she told attendees of the Masters of the American Society of Retina Specialists meeting. Seven eyes had serous pigment epithelial detachment (SPED), five had choroidal neovascularization (CNV) due to age-related macular degeneration, and two had angioid streaks.

“The patients had to have CNV unresponsive to other therapies and had to have subretinal fluid,” Dr. Pollack said. Patients were injected with 1.25 mg of Avastin, and follow-up was at 1 day, 1 and 4 weeks and 2 months, she said.

Of seven eyes at 1 week, three had improved between 8 and 15 letters, three showed no improvement, and one regressed, “but that eye had hyphema,” she said. Optical coherence tomography showed three eyes improving, two eyes without a change and two eyes regressing.

“The need for re-treatment was based on visual acuity measurement, evidence of subretinal fluid on clinical examination and OCT or leakage on fluorescein angiography,” she said.

Of the seven eyes with SPED, three showed visual acuity improvement. “One eye improved by four lines,” she said. Four eyes maintained vision at all follow-up points.

Ten eyes had a mild conjunctival injection on the first postop day that resolved spontaneously. None of the eyes showed an increase of IOP, Dr. Pollack said.

“Overall, VA did improve, but regression may occur,” she said.