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LONG-TERM OUTCOMES OF INTRAVITREAL ANTIVASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR THE MANAGEMENT OF CHOROIDAL NEOVASCULARIZATION IN PSEUDOXANTHOMA ELASTICUM

MYUNG, JANE S. MD*†‡; BHATNAGAR, PAWAN MD†‡§; SPAIDE, RICHARD F. MD†‡; KLANCNIK, JAMES M. Jr MD†‡; COONEY, MICHAEL J. MD, MBA†‡; YANNUZZI, LAWRENCE A. MD†‡; FREUND, K. BAILEY MD*†‡

doi: 10.1097/IAE.0b013e3181c596b1
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Purpose: The purpose of this study was to report long-term results of intravitreal antivascular endothelial growth factor therapy in the management of choroidal neovascularization in patients with angioid streaks associated with pseudoxanthoma elasticum.

Methods: A consecutive series of patients with pseudoxanthoma elasticum and choroidal neovascularization were managed with intravitreal antivascular endothelial growth factor injections (bevacizumab 1.25 mg/0.05 mL or ranibizumab 0.5 mg/0.05 mL). The main outcome measures were visual acuity and greatest lesion height as measured by optical coherence tomography.

Results: Nine eyes of nine consecutive patients received intravitreal antivascular endothelial growth factor therapy. During the mean follow-up period of 28.6 months, eyes received an average of 8.4 injections. At baseline, the mean visual acuity was 20/368 (median, 20/60) and improved to 20/281 (median, 20/40) at the last visit (P = 0.14). Visual acuity either improved or stabilized in all 9 eyes (100%). Serial optical coherence tomography measurements showed a mean of 353 μm at baseline and decreased to 146 μm at the last visit (P = 0.005). No complications were noted.

Conclusion: These long-term results support the use of intravitreal antivascular endothelial growth factor therapy for the management of choroidal neovascularization in patients with pseudoxanthoma elasticum. Continued experience with intravitreal bevacizumab or ranibizumab in this population will help establish long-term efficacy and better define optimal dosing strategies.

A retrospective analysis of nine patients treated with intravitreal antivascular endothelial growth factor for choroidal neovascularization in pseudoxanthoma elasticum was evaluated for visual acuity and optical coherence tomography thickness outcomes. All patients achieved either stabilization or improved visual acuity and decreased lesion height at the end of this long-term study.

From the *Department of Ophthalmology, New York University School of Medicine; †LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Institute; ‡Vitreous-Retina-Macula Consultants of New York; and §Department of Ophthalmology, Mt. Sinai School of Medicine, New York, New York.

Supported by the Macula Foundation, Inc.

Presented at the Annual Meeting of the Retina Society, September 25–28, 2008, Scottsdale, Arizona.

The authors have no financial or proprietary interest in any aspect of the article.

Reprint requests: K. Bailey Freund, MD, Vitreous Retina Macula Consultants of New York, 460 Park Avenue, 5th Floor, New York, NY 10022; e-mail: kbfnyf@aol.com

© The Ophthalmic Communications Society, Inc.