We greatly appreciated Dr Jonas’ interest in and comments on our recent study, and we thank him for sharing his experience in the treatment of complicated retinal arterial macroaneurysms with intravitreal bevacizumab. Dr Jonas raises an important point on the possible use of a single injection rather than a regimen of 3 injections, and we address his point herein. In addition to Dr Jonas’s study, the cases reported in literature base their anatomical and functional results on a mean of 2 intravitreal injections.

The decision to design the treatment protocol of our prospective study as a 3-month therapy was based only on the vast clinical experience of the ophthalmologic community with intravitreal anti–vascular endothelial growth factor in age-related macular degeneration. Therefore, we chose to adhere to the same regimen.

From a research point of view, it is important to note that a standardized regimen was used and that the primary endpoints were achieved in all our patients; from a clinical perspective, we believe that the dosage used in our study was adequate for some patients and excessive for others, but no side effects were noted.

In conclusion, we would like to state that at this time there is a certain degree of uncertainty on the correct treatment regimen, but we believe that accurate follow-up and personal experience of the single ophthalmologist remain the best “weapons” to approach such cases. We strongly encourage further investigation on this topic, which may shed light on the ideal regimen.

Once again, we thank Dr Jonas for discussing an important issue related to the use of intravitreal bevacizumab in the treatment of complicated macroaneurysms.