PRESENTING AUTHOR : Dr. UMESH BHAMMARKAR

CO –AUTHOR: Dr. DEEPTI MEHTA

INSTITUTE: LIONS CLUB OF HYDERABAD

SADHURAM EYE HOSPITAL HYDERABAD

Introduction:In a significant number of young patients

with choroidal neovascular membrane (CNVM), no apparent cause can be detected; constituting Idiopathic CNV.

Only a few reports exist in the literature about idiopathic CNVM in young ages.

We report Three cases of idiopathic CNVM in young patients with no evidence of any predisposing factor, which responded favourably to Intravitreal bevacizumab injection.

Material and Methods:Three cases of idiopathic CNVM are

described in our study, a 17 years old female ,21 and 24 years old male patient. On initial examination vision was 6/60 ,6/36and 5/60 respectively.

Fundus Fluorescein Angiography(FFA) showed a well-defined hyper fluorescent area corresponding to the CNVM.

Optical Coherence Tomography (OCT) showed intraretinal fluid that is consistent with an active CNV.

Material and Methods:To exclude the possibility of ongoing

inflammation, a close biomicroscopic examination and laboratory investigations were performed.

However, there was no evidence of vitreous cells, condensation or vasculitis.

There was no evidence of any systemic disease and trauma.

FFA & OCT AFTER TREATMENT

FFA & OCT BEFORE TREATMENT

Results:Three doses of Intravitreal Bevacizumab

(Avastin) (1.25 mg/0.05 mL ) was injected into diseased eyes at monthly interval , and at a 3 months follow-up visit, visual acuity improved to 6/9(p) in female patient, 6/6 and 6/6 (p) in males.

In all patients, the CNV regressed, intraretinal fluid was absorbed, and visual acuity improved significantly after anti-VEGF injection.

Result.....No adverse effect attributable to the drug or

procedure were encountered in the follow-up period.

All patients are under follow-up, and a re-injection would be performed if there is recurrence of activity.

FFA & OCT BEFORE TREATMENT

FFA & OCT AFTER TREATMENT

Conclusion:Idiopathic CNV are usually unilateral and final

visual outcomes are considered to be more favorable than CNVM due to other causes.

Intravitreal bevacizumab has excellent result in idiopathic CNV and advantages are that it safe, well tolerated, easily available, cost effective and can be repeated as needed.

Both FFA and OCT are helpful in diagnosis and monitoring the response of treatment.

TAKE HOME MESSAGEIntravitreal bevacizumab has excellent result

in idiopathic CNV .

It is safe, well tolerated, easily available, cost effective and can be repeated as needed.

Both FFA and OCT are helpful in diagnosis and monitoring the response of treatment.