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Is Intravitreal Bevacizumab an Effective Treatment Option for Nonarteritic Anterior Ischemic Optic Neuropathy?

Prescott, Christina Rapp MD, PhD; Sklar, Craig A. MD; Lesser, Robert L. MD; Adelman, Ron A. MD, MPH

Journal of Neuro-Ophthalmology: March 2012 - Volume 32 - Issue 1 - p 51–53
doi: 10.1097/WNO.0b013e318240596e
Clinical Observation

Abstract: Nonarteritic anterior ischemic optic neuropathy (NAION) causes sudden profound loss of vision with no known cause or cure. Various treatment modalities, both surgical and pharmacologic, have been tried without success. The purpose of our retrospective study was to evaluate the effect of intravitreal bevacizumab (Avastin) as a treatment option for NAION. We evaluated demographics of 5 patients and compared visual acuity and automated visual fields prior to and following intravitreal bevacizumab injection. Visual acuity at presentation was 20/20 in 4 of 5 patients and 20/150 in 1. Visual acuity improved to 20/40 in the patient who presented with decreased acuity and decreased slowly in 3 patients and rapidly in 1. All patients presented with variable visual field defects: 1 improved slightly, 3 progressed, and 1 remained stable. One patient subsequently developed NAION in the fellow eye. These results are consistent with the natural course of the disease, and bevacizumab did not appear to have a dramatic effect on the clinical outcome in this small series of patients with NAION.

Department of Ophthalmology and Visual Science (CRP, CAS, RLL, RAA), Yale University School of Medicine, New Haven, Connecticut.

Address correspondence to Ron A. Adelman, MD, MPH, Department of Ophthalmology and Visual Science, Yale University School of Medicine, 40 Temple Street, 3rd Floor, New Haven, CT 06510; E-mail:

Supported by Leir Foundation, Newman's Own Foundation, and Research to Prevent Blindness.

The authors report no conflicts of interest.

© 2012 Lippincott Williams & Wilkins, Inc.