*6.2. Palliative Treatment: An Ocular Therapy for PXE*

As described above, PXE leads to severe visual impairment as a consequence of choroidal neovascularizations resulting from angioid streaks. Visual loss is one of the PXE manifestations that impacts quality of life the most. Photodynamic therapy has been explored but was not found to be effective [162]. Because the monoclonal antibody against the vascular endothelial growth factor (VEGF–Bevacizumab) has been shown to be beneficial for the treatment of choroidal neovascularizations secondary to age-related macular degeneration [163], which present many similarities with PXE, Finger et al. performed a retrospective analysis with a small cohort of PXE patients to determine the effectiveness of repeated intravitreal injections of Bevacizumab on visual acuity and morphologic outcomes [24]. The results were unequivocal in showing that this therapy preserved ocular function in cases of advanced disease and improved function in early stages. As a result, anti-VEGF therapy has become a common symptomatic treatment for PXE patients.
