Intravitreal Bevacizumab for Retinal Neovascularizations Associated with Myelinated Nerve Fibers

Purpose: To report the effects of intravitreal bevacizumab injection (IVBI) in a patient affected by retinal neo-vascularizations (RNVs) associated with myelinated nerve fibers (MNF) and complicated by vitreous hemorrhage. Methods: A 23-year-old female was referred because of sudden visual acuity deterioration in the left eye. Nine years earlier, the subject underwent retinal laser photocoagulation for recurrent vitreous hemorrhages related to the development of RNV associated with MNF. The ophthalmological evaluation revealed a new recurrence of vitreous hemorrhage associated with fluorescein leakage from RNV. After careful discussion, the patient underwent IVBI. Results: One month after the injection, the best corrected visual acuity (BCVA) improved from 20/400 to 20/100, with a vitreous hemorrhage resolution, and cessation of fluorescein leakage. Over the 24-month follow-up, 2 additional IVBIs were administered due to further vitreous hemorrhage associated with fluorescein leakage from RNV, achieving a final BCVA of 20/80. Conclusions: IVBI may temporarily counteract the vascular hyperpermeability typical of RNV associated with MNF, leading to the cessation of fluorescein leakage, but does not result in RNV regression.