Non-leaking MCS occur in a variety of retinal dystrophies. Therapy with topical or systemic CAI has variable efficacy and may result in VA improvement with or without qualitative improvement in MCS and CFZ thickness.

As the patient had new VH and persistent leakage from NVD after aggressive PRP, he was offered intravitreal bevacizumab OD, after a full discussion of its off-label nature and potential risks. Using a sterile protocol, 4 0.05 cc (1.25 mg) of bevacizumab was injected intravitreally OD.One week later, vision measured 20/25 þ 2 OD, the VH had cleared, and the NVD appeared fibrotic OD. Fluorescein angiography (Figure 2) showed dramatic regression and cessation of leakage from NVD. CommentThis case illustrates rapid cessation of leakage from NVD 1 week following adjunctive intravitreal bevacizumab. Although it may be argued that PRP caused regression of NVD, examination and fluorescein angiography 5 weeks after PRP showed new VH and persistent leaking NVD, which stopped leaking 1 week after intravitreal bevacizumab. As PRP is the standard of care for high-risk PDR, 5 it was only after maximal PRP that we offered the patient off-label adjunctive treatment. Further studies are needed to determine the role of bevacizumab in the management of PDR. References

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