The use of bevacizumab in a multilevel retinal hemorrhage secondary to retinal macroaneurysm: a 39-month follow-up case report

Dimitrios Tsakpinis¹, Mayssa B Nasr^1,2, Paris Tranos³, Nikos Krassas¹, Theodoros Giannopoulos², Chrysanthos Symeonidis¹, Stavros A Dimitrakos¹, Anastasios GP Konstas^2
12nd University Department of Ophthalmology, Papageorgiou Hospital; ²Glaucoma Unit, 1st University, Department of Ophthalmology, AHEPA Hospital, Thessaloniki, Greece; ³Retina Eye Center, Thessaloniki, Greece

Purpose: The evaluation of long-term visual outcome after the use of bevacizumab for the management of multilevel hemorrhage due to retinal arterial macroaneurysm (MA).
Case report: A 71-year-old hypertensive female presented with sudden reduction of visual acuity in her left eye (OS). Fundoscopy revealed an arterial macroaneurysm with preretinal and subretinal hemorrhage in the eye. Due to significant macular involvement, the patient received two intravitreal injections of bevacizumab within 2 months.
Results: Significant visual and anatomical recovery was observed 2 months later, which was confirmed by fluorescein angiography. At the end of a follow-up period (39 months) visual acuity and visual field were at normal levels.
Conclusion: Retinal MA is a relatively rare condition. Anti-vascular endothelial growth factor therapy appears a safe and effective treatment option for selected symptomatic individuals that may offer faster visual rehabilitation. Herein we report, for the first time, a 39-month follow-up of a retinal MA treated with anti-vascular endothelial growth factor therapy.

Keywords: arterial retinal macroaneurysm, anti-VEGF, bevacizumab, multilevel hemorrhage