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Bilateral response following unilateral intravitreal bevacizumab injection in a child with uveitic cystoid macular edema

2009; Elsevier BV; Volume: 13; Issue: 4 Linguagem: Inglês

10.1016/j.jaapos.2009.03.006

1528-3933

Hassan Al-Dhibi, Arif O. Khan,

Retinal and Optic Conditions

Untreated cystoid macular edema (CME) is a major cause for visual loss in intermediate and posterior forms of uveitis. Conventional treatments for inflammatory CME include steroids, nonsteroidal antiinflammatory agents, and carbonic anhydrase inhibitors; however, not all patients respond, even after quieting of the uveitis. Intravitreal injection of bevacizumab, a monoclonal antibody to vascular endothelial growth factor, has recently been suggested as a short-term treatment for inflammatory CME in adults. Because unilaterally injected bevacizumab can reach the contralateral eye via the systemic circulation there may be a contralateral clinical effect; however, the few reports that evaluate this in adults are conflicting. The purpose of this report is to document bilateral reduction of uveitic CME following unilateral intravitreal bevacizumab injection in an 8-year-old girl. Untreated cystoid macular edema (CME) is a major cause for visual loss in intermediate and posterior forms of uveitis. Conventional treatments for inflammatory CME include steroids, nonsteroidal antiinflammatory agents, and carbonic anhydrase inhibitors; however, not all patients respond, even after quieting of the uveitis. Intravitreal injection of bevacizumab, a monoclonal antibody to vascular endothelial growth factor, has recently been suggested as a short-term treatment for inflammatory CME in adults. Because unilaterally injected bevacizumab can reach the contralateral eye via the systemic circulation there may be a contralateral clinical effect; however, the few reports that evaluate this in adults are conflicting. The purpose of this report is to document bilateral reduction of uveitic CME following unilateral intravitreal bevacizumab injection in an 8-year-old girl. See editorial on page 329. Extrapolating anti-vascular endothelial growth factor therapy into pediatric ophthalmology: Promise and concernJournal of American Association for Pediatric Ophthalmology and Strabismus {JAAPOS}Vol. 13Issue 4PreviewThe use of anti-vascular endothelial growth factor (VEGF) agents has dramatically changed the way we treat many retinal diseases.1-3 This paradigm shift in treatment is due to the ability of these drugs to inhibit VEGF, a molecule that has a pivotal role in a large variety of retinal conditions, including age-related macular degeneration (AMD), proliferative diabetic retinopathy, retinal vein occlusion, retinopathy of prematurity (ROP), and many forms of retinal edema. Intravitreal ranibizumab (Lucentis; Genentech, San Francisco, CA) is currently FDA approved for the treatment of neovascular AMD. Full-Text PDF