Editor, A 75-year-old man presented with subacute loss of visual acuity (VA) to 20/100 in his left eye. Ophthalmoscopy showed a peripapillary and foveal retinal oedema, and fluorescein angiography revealed a peripapillary classic choroidal neovascularization secondary to age-related macular degeneration (AMD) (Fig. 1A, B). The lesion measured 1.32 mm2. Optical coherence tomography demonstrated submacular fluid and an elevation of the macula to 450 µm (Fig. C). Visual acuity and ophthalmoscopy of the right eye were unremarkable. Baseline data. Fluorescein angiography (FA) demonstrates (A) classic peripapillary choroidal neovascularization, with (B) leakage in the late phase. The arrow in (A) indicates the direction of the optical coherence tomography (OCT) scan (C). Scan by OCT of the macula shows marked subretinal fluid and the choroidal neovascular lesion on the right side. Macular thickness was measured with 450 µm and visual acuity was 20/100. An intravitreal off-label injection of 1.5 mg bevacizumab was recommended. The patient was fully informed of the experimental character of the treatment and gave signed informed consent. The operation was performed in the sterile setting of an operating room. Six months after the single injection, VA had increased from 20/100 to 20/25. Fluorescein angiography demonstrated a reduction in lesion size from 1.32 mm2 to 1.22 mm2 in the early phase and a marked reduction or complete loss of leakage in the late phase, with a remaining transparency defect of the retinal pigment epithelium (Fig. 2A, B). Optical coherence tomography demonstrated a complete resorption of the submacular fluid, leading to thinning of the macula to 175 µm. In the peripapillary region, a residual subretinal thickening could be detected in the area of the former subretinal classic neovascular membrane (Fig. 2C). Data from 6-month follow-up after a single intravitreal injection of bevacizumab. Fluorescein angiography demonstrates (A) reduction of the choroidal neovascular membrane size from 1.35 mm2 to 1.20 mm2, and (B) reduction of leakage in the late phase. The arrow in (A) indicates the direction of the optical coherence tomography (OCT) scan. (C) Scan by OCT of the macula reveals resolution of submacular fluid and thinning of the macula from 450 µm to 175 µm. On the right side of the OCT scan, a residual subretinal thickening represents the former subretinal peripapillary choroidal neovascular membrane. Visual acuity was 20/25. Early studies on bevacizumab showed an increase in VA when the drug was applied intravenously or intravitreally in patients with exudative AMD (Rosenfeld et al. 2005; Spandau et al. 2006; Avery et al. 2006) demonstrated an improvement in VA and decrease in subfoveal fluid following intravitreal bevacizumab for exudative AMD. In a recent study of photodynamic therapy for treatment of peripapillary subretinal neovascularization, the majority of patients required two treatments for the resolution of leakage (Rosenblatt et al. 2005). Given the present report, it remains unclear whether photodynamic therapy or intravitreal bevacizumab injection alone or a combination of both treatment modalities have the best outcome for subfoveal or extrafoveal choroidal neovascularization. The present report suggests that, in some patients, a single intravitreal injection of bevacizumab may induce a reduction in size and a closure of the subretinal neovascular membrane, leading to a resolution of subretinal leakage and increase in VA. Further studies are warranted to elucidate the optimal therapeutic regimen for subretinal peripapillary choroidal neovascularization.