Macular detachment after successful intravitreal bevacizumab for myopic choroidal neovascularization

Abstract

To determine the incidence and features of macular retinal detachment (RD) after successful intravitreal injection of bevacizumab (IVB) for the treatment of myopic choroidal neovascularizations (CNVs). Seventy-four eyes of 74 patients who received IVB for myopic CNV were studied. Fluorescein angiography (FA) and optical coherence tomography (OCT) were performed at baseline, at 1 week after IVB, and every month thereafter. The shortest follow-up period was 6 months. Four eyes (5.4%) either developed or had increased macular RD after successful IVB. In the three eyes, macular RD newly developed 1 month after IVB despite the absence of dye leakage. The remaining eye had a limited area of macular RD at baseline and increased despite the disappearance of dye leakage from the CNV after the IVB. The four eyes that developed a macular RD had retinoschisis around the CNV before IVB, whereas none of the 70 other patients had a retinoschisis throughout the follow-up period. In all four eyes that either developed or had increased macular RD, outer lamellar holes were detected at the upper edge of the RD by OCT examinations, whereas none of the patients who did not develop a macular RD after IVB showed outer lamellar holes. These results suggest that there is a risk of developing macular RD after IVB in eyes with myopic CNV. Periodic OCT examinations are recommended for patients with myopic CNV to search for RDs after IVB.