Intravitreal Bevacizumab for Proliferative Sickle Retinopathy: A Case Series

Purpose: To report outcomes of intravitreal bevacizumab therapy for proliferative sickle retinopathy (PSR). Methods: A retrospective, interventional case series. Five eyes of 5 patients with PSR were managed with intravitreal bevacizumab therapy over a 13-year period at a single institution. Results: Four patients had sickle cell-hemoglobin SC disease and 1 had sickle cell-beta thalassemia disease. Four of the patients treated with intravitreal bevacizumab injection were treated for recurrent vitreous hemorrhage and 1 was treated for new peripheral sea fan neovascularization. In those patients treated for vitreous hemorrhage, there was improvement in visual acuity as early as 2 weeks after treatment. Only 2 of the patients had documented recurrent vitreous hemorrhage during the period of follow-up after the initial injection. In 1 patient, the vitreous hemorrhage did not recur until 13 months after the injection. All patients showed an anatomic response to intravitreal bevacizumab therapy with partial regression of the peripheral sea fan neovascularization. All patients tolerated the injections without any complications. Conclusions: Intravitreal bevacizumab injections appear to be well tolerated and may be an effective treatment of PSR. Regression of peripheral sea fan neovascularization and decreased duration of vitreous hemorrhage may be observed. Large-scale randomized controlled trials are needed to further clarify the role of bevacizumab in PSR.