Treatment of total exudative retinal detachment due to central retinal vein occlusion by intravitreal bevacizumab in a patient with p-ANCA vasculitis

OBJECTIVE To report on the use of intravitreal bevacizumab (an anti-vascular endothelial growth factor [VEGF] monoclonal antibody) as treatment of diffuse exudative retinal detachment due to ischemic central retinal vein occlusion (CRVO). DESIGN Interventional case report. PATIENT A 27-year old woman on peritoneal dialysis because of end stage renal failure (ESRF) due to perinuclear antineutrophil cytoplasmic antibody (p-ANCA) associated vasculitis presented with acute unilateral blurred vision. Visual acuity (VA) rapidly deteriorated. Examination revealed the development of total bullous exudative retinal detachment following ischemic CRVO. INTERVENTION Two intravitreal injections of bevacizumab (2.5 mg/0.1ml) were administered followed by panretinal laser photocoagulation. MAIN OUTCOME MEASURES VA, retinal detachment, and changes in macular edema. RESULTS Prompt significant resolution of exudative retinal detachment with a corresponding gradual improvement of VA from light perception to finger counting. At follow-up examination after 8-months, the retina remained attached. CONCLUSION Intravitreal bevacizumab proved to be a useful treatment modality in diffuse exudative retinal detachment due to CRVO.