title: Intravitreal bevacizumab treatment of choroidal neovascularization secondary to age-related macular degeneration.
abstract: OBJECTIVE
  To describe the short-term anatomical and visual acuity responses after intravitreal injection of bevacizumab (Avastin, Genentech) in patients with choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
  
  
  METHODS
  We conducted a retrospective study of patients with CNV secondary to AMD who were treated with intravitreal injection of bevacizumab (1.25 mg) during a 3-month period. Patients underwent best-corrected Snellen visual acuity testing, optical coherence tomography, and ophthalmoscopic examination at baseline and follow-up visits.
  
  
  RESULTS
  There were 266 consecutive eyes of 266 patients who received injections, and follow-up information was available for 251 (94.4%). The mean age of the patients was 80.3 years, the mean baseline visual acuity was 20/184, and 175 (69.7%) had inadequate response to alternate methods of treatment. At the 1-month follow-up (data available for 244 patients), the mean visual acuity was 20/137 (P < 0.001 as compared with baseline), and 74 (30.3%) of patients had improvement in visual acuity as defined by a halving of the visual angle. At the 2-month follow-up (data available for 222 patients), the mean visual acuity was 20/122 (P < 0.001), and 78 (31.1%) of patients had visual improvement. At the 3-month follow-up (data available for 141 patients), the mean visual acuity was 20/109 (P < 0.001), and 54 (38.3%) of patients had visual acuity improvement. The mean central macular thickness at baseline was 340 mum and decreased to a mean of 247 microm at month 1 (P < 0.001) and 213 microm at month 3 (P < 0.001). At 1 month, two patients had mild vitritis, as did one patient at 2 months, who had a history of recurrent uveitis. No endophthalmitis, increased intraocular pressure, retinal tear, or retinal detachment occurred. The risk for thromboembolic disorders did not seem to be different than reported previously in studies concerning macular degeneration.
  
  
  CONCLUSIONS
  There were no apparent short-term safety concerns for intravitreal bevacizumab injection for CNV. Treated eyes had a significant decrease in macular thickness and improvement in visual acuity. The follow-up was too short to make any specific treatment recommendations, but the favorable short-term results suggest further study is needed.
authors.affiliation: Vitreous Retina Macula Consultants of New York and the LuEsther T. Mertz Retinal Research Center at Manhattan Eye, Ear & Throat Hospital, 460 Park Avenue, New York, NY 10022, USA. vrmny@aol.com
authors.forename: Richard F
authors.initials: RF
authors.lastname: Spaide
authors.forename: Ketan
authors.initials: K
authors.lastname: Laud
authors.forename: Howard F
authors.initials: HF
authors.lastname: Fine
authors.forename: James M
authors.initials: JM
authors.lastname: Klancnik
authors.forename: Catherine B
authors.initials: CB
authors.lastname: Meyerle
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Yannuzzi
authors.forename: John
authors.initials: J
authors.lastname: Sorenson
authors.forename: Jason
authors.initials: J
authors.lastname: Slakter
authors.forename: Yale L
authors.initials: YL
authors.lastname: Fisher
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Cooney
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000276:immunology; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab