• Courtesy of Richard F. Spaide, MD.
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    Expansion of CNV after treatment with photodynamic therapy followed by bevacizumab. A, This patient was treated with photodynamic therapy for myopic choroidal neovascularization with leakage. Note the rings of pigment centrally, indicating successive expansions of the lesion. B, After treatment, the lesion expanded even more. Note the increased pigment (arrow). C, After several photodynamic therapy treatments, the lesion expanded further (arrow),and a hemorrhage developed (arrowhead). Visual acuity was 20/80. D, Fluorescein angiography image reveals the extent of the neovascularization. The patient was given an injection of intravitreal bevacizumab 1.25 mg. E, The patient received 2 additional injections over time. Six years after first being treated with bevacizumab, the patient has some residual hyperpigmentation, but also a wide area of pigmentary loss. Visual acuity was 20/60. F, Nearly 10 years after injection, the atrophy continued to expand.