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.