Intravitreal Bevacizumab for Choroidal Neovascularization With Large Submacular Hemorrhage in Age-Related Macular Degeneration

Purpose To assess the effects of intravitreal bevacizumab (Avastin) injections in the treatment of choroideal neovascularization (CNV) with large submacular hemorrhage (LSH) secondary to age-related macular degeneration (AMD). Methods Prospective interventional case series. Patients with occult CNV with LSH greater the 50% of the entire lesion were considered. The protocol required 3 monthly consecutive injections, followed by repeat injections over the 12-month follow-up on the basis of OCT parameters, angiographic features, visual acuity response. Results Eight patients were enrolled in the study and prospectively followed up. Mean visual acuity and mean foveal thickness (FT) at baseline were 0.72±0.35 (logMAR±SD) and 296±86µm SD, respectively. At three-month examination, mean visual acuity improved to 0.46±0.28 SD and mean FT decreased to 240±105µm SD. At 12-month examination, mean visual acuity was 0.48±0.32 SD, and mean FT 238±50µm SD. A progressive resolution of macular bleeding was registered in 7 patients. Neither side-effect or complication was registered. Conclusions Intravitreal bevacizumab seems to be a beneficial treatment for CNV with LSH secondary to AMD. A randomized clinical trial with greater number of patients and control group is needed to confirm our preliminary results.