Intraocular Anti-VEGF Therapy For Intraocular Tumors-Case Report And Literature Review

Intraocular tumors include primary and metastatic tumors, most of them happen in the retina and uvea. Intraocular tumor is a serious blinding disease, and malignant tumors can even endanger the patient’s life. Proper treatment is vital for maintaining the visual function and prolonging the life of patients. The incidence of intraocular tumor is relatively low, if the tumor is small and locate in the peripheral retina, it usually causes no obvious clinical symptoms. Tumors involving the macula or optic disc often cause irreversible blurred vision. Tumors that grow fast can easily invade adjacent tissues, and can metastasis to all parts of the body via the blood or lymphatic system; once the brain is invased, the patient’s life can be seriously threaten. Therefore, timely diagnosis and effectively treatment is essential to prolong the lives of patients and improve the quality of life.In our thesis, we presented with four cases of intraocular tumors that received intraocular injection of lucentis---an anti-vascualr endothelial growth factor. Among the four cases, two were choroidal metastases, one was choroidal osteoma with secondary choroidal neovascularization, one was choroidal hemangioma underlying the macular region. All of them went to the hospital due to decreased vision. Two patients with choroid metastatic carcinoma received intraocular injection of anti vascular endothelial growth factor, and their ocular condition maintained stable or improved for 1.5 years and half year respectively. The patient with choroidal neovascularization secondary to choroidal osteoma received one intravitreal injection of anti-vascular endothelial growth factor, and the visual acuity remained stable for about 3 months. The fourth patient with macular choroidal hemangioma received one intravitreal anti-vascular endothelial growth factor, and the visual acuity was still in stable condition, when follow-up visits stopped 5 month after the injection.There is a variety of treatments for intraocular tumors such as radiation therapy, laser therapy, chemotherapy, surgery and anti-angiogenesis therapy.Each method has its advantages and disadvantages and the relative indications. This paper will discuss and exchange experience on the Intraocular injection of Anti-Vascular Endothelial Growth Factor:therapy for the treatment of intraocular tumor. Vascular endothelial growth factor (VEGF) is considered to be an important factor promoting a pathological or physiological angiogenesis. VEGF can not only promote tumor angiogenesis, vascular permeability changes, it can also adjust the important signaling pathways of tumor origenesis, including the origin of cancer stem cells and tumor cells function. The drugs currently used for intravitreal injection include bevacizumab, ranibizumab, aflibercept, the characters and mechanisms of these anti-VEGF drugs will also be discussed in detail.