AIM: To observe the consequence of transplantation of autologous RPE-Bruch membrane complex and intravitreal injection of bevacizumab(Avastin)for the occult choroidal neovascularization(CNV).

METHODS: A retrospective study was performed in 34 patients(35 eyes)with the massive occult CNV accompanied by the wide-ranging subretinal hemorrhage that underwent different treatment and related literatures were reviewed. The 34 patients(35 eyes)were divided to group A(the treatment methods include the macular subretinal hemorrhage and CNV removal surgery, intravitreal injection of bevacizumab, combination of PDT and intravitreal injection of bevacizumab, laser photocoagulation)and group B(transplantation of autologous RPE-Bruch membrane complex and intravitreal injection of bevacizumab). The outcome was measured before and after therapy by best-corrected visual acuity(BCVA), intraocular pressure(IOP), multifocal ERG(mfERG), optical coherence tomography(OCT), fluorescein angiography(FFA), indocyanine green angiography(ICGA). Autofluorescence tests were also conducted.

RESULTS: During 11.7±6.5 months of follow-up after the end of therapy, the BCVA of group B was elevated in 10 eyes(71.43%, 10/14), constant in 2 eyes(14.29%, 2/14)and decreased 2 eyes(14.29%, 2/14). Besides, no recurrent CNV in group B was found. The BCVA of group B was 4.3±1.1, improving significantly compared with 3.5±0.4 of group B before therapy(P<0.05)and 3.4±0.3 of group A after the end of therapy(P<0.05). The posterior pole retinal average thickness measured by fast macular scans using OCT of group B was 236±71μm, decreasing notably compared with 371±97μm of group B before therapy(P<0.05)and 364±86μm of group A after the end of therapy(P<0.05).

CONCLUSION: The short-term results of transplantation of autologous RPE-Bruch membrane complex and intravitreal injection of bevacizumab are confirmed and it could increase the visual acuity of patients with the massive CNV accompanied by the wide-ranging subretinal hemorrhage. This positive intervention should be noted in order to save the visual function of such patients.