Anti-vascular Endothelial Growth Factor for Choroidal Neovascularization Associated with Toxoplasmosis: A Case Series Farzan Kianersi 1 , Zahra Naderi Beni 2 , Afsaneh Naderi Beni 2* , Heshmatollah Ghanbari 1 and Mostafa Ahmadi 2 1 Department of Ophthalmology, Isfahan University of Medical Science, Isfahan, Iran 2 Shahrekord University of Medical Sciences, Shahrekord, Iran * Corresponding author: Afsaneh Naderi Beni, Shahrekord University of Medical Sciences, Shahrekord, Iran, Tel: +98-381-2224400; E-mail: a_naderibeni@yahoo.com Received date: June 17, 2015, Accepted date: August 21, 2015, Published date: August 31, 2015 Copyright: © 2015 Kianersi F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract The purpose of the study was to evaluate the efficacy and safety of intravitreal anti-vascular endothelial growth factor (anti-VEGF) in treatment of choroidal neovascularization (CNV) secondary to toxoplasmic retinochoroiditis in five patients. After six months the CNV resolved as confirmed by fluorescein angiography and optical coherence tomography (OCT) in all patients. The visual acuity improved from mean 20/400 to 20/80 and Central Macular Thickness (CMT) decreased from 390 μm to 253 μm, which was maintained till the last follow-up visit. Keywords: Anti-vascular endothelial growth factor; Choroidal neovascularization; Toxoplasmosis Introduction Treatment modalities for choroidal neovascularization (CNV) due to ocular toxoplasmosis include laser photocoagulation, surgery, corticosteroids, and verteporfin therapy. Intravitreal injection of Anti- vascular endothelial growth factor (anti-VEGF ) in the treatment of CNV due to other conditions appears to be an effective and safe therapeutic option. We report 5 cases of successful treatment with anti-VEGF for symptomatic CNV due ocular toxoplasmosis. Methods The Isfahan University Medical Center approved this study. Our study population consisted of 5 patients with CNV due to ocular toxoplasmosis (3 women, 2 men) with a mean (SD) age of 27.2 (7.1) years, all with documented notes suggested of clinical and serological diagnosis of toxoplasmosis retinichoriditis and had been treated with oral sulfadiazine and pyrimethamine, along with systemic steroids at least 6 months before referral to our clinic. All patients received a complete ophthalmologic evaluation. The anterior chamber and vitreous cavity were quiet in all patients. No signs suggestive of age-related macular degeneration were found. Fluorescein (FA) criteria included evidence of leakage caused by CNV (100% classic without an occult component) secondary to ocular toxoplasmosis and presence of intraretinal or subretinal fluid documented by optical coherence tomography (OCT). Intravitreal anti-VEGF treatment was recommended for all patients (bevacizumab, 1.25 mg for 4 eyes and ranibizumab 0.5 mg for one eye). Results CNV was inactive in all eyes after Intravitreal anti-VEGF treatments with an absence of leakage demonstrated by fluorescein angiography, complete disappearance of exudative signs and reduction of retinal thickness shown by OCT (Figure 1). Figure 1: Fluorescein angiography (FA) and OCT before and after treatment in 5 cases with choroidal neovascularization associated with toxoplasmosis. The mean follow-up was 14.4 months (range 6–24 months). Pre- injection visual acuity measured 20/250 or worse in all eyes. According to the last follow-up examination, visual acuity measured 20/30, 20/200, 20/200, 20/100 and 20/100 in eyes (Table 1). Mean Central macular thickness (CMT) at baseline was 399 μm (380-410 μm). At the last check, mean CMT reduction was 149 μm (65-175 μm), with a mean thickness of 253 μm (range, 215-300 μm) (p=0.0002). Kianersi et al., J Clin Exp Ophthalmol 2015, 6:4 DOI: 10.4172/2155-9570.1000463 Short Communication Open Access J Clin Exp Ophthalmol ISSN:2155-9570 JCEO, an open access journal Volume 6 • Issue 4 • 1000463 Journal of Clinical & Experimental Ophthalmology J o ur n a l o f C l i n ic a l & E x pe r i m e n t a l O p h t h a l m o lo g y ISSN: 2155-9570