Expression of vascular endothelial growth factor and intravitreal anti-VEGF therapy with bevacizumab in vasoproliferative retinal tumors.

Purpose: To examine whether vasoproliferative retinal tumors (VPRTs) express vascular endothelial growth factor and respond to intravitreal bevacizumab injection. Methods: Retrospective interventional case series. Intravitreal bevacizumab 1.25 mg was administered to 9 patients with VPRT-associated neovascularization or exudative retinal changes. The changes of the tumor size, best-corrected visual acuity, and central retinal thickness were evaluated before and after treatment. Immunohistochemistry with anti-vascular endothelial growth factor antibody in an excised tissue of VPRT during pars plana vitrectomy was performed. Results: In two patients with small tumors (within two disk diameters), the tumors disappeared or regressed with only one injection of intravitreal bevacizumab injection. Larger tumors regressed after additional laser photocoagulation and/or cryotherapy without recurrence of exudative retinal changes in six eyes, although these did not regress by intravitreal bevacizumab injection alone. The mean logarithm of the minimal angle of resolution value of best-corrected visual acuity and central retinal thickness at the final visit were significantly improved compared with those of pretreatment (P = 0.02 and P = 0.03, respectively). Immunoreactivity for vascular endothelial growth factor was strongly detected in the resected tumor tissue. Conclusion: These results suggest that vascular endothelial growth factor derived from VPRTs causes retinal neovascularization or exudative retinal changes associated with VPRTs. Intravitreal bevacizumab may be a useful therapeutic option for these complications secondary to VPRTs.