title: Intravitreal bevacizumab (Avastin) treatment of neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To report the change in visual acuity and central retinal thickness by optical coherence tomography (OCT) after intravitreal injections of bevacizumab for the treatment of neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  A retrospective case series in a university-based practice evaluated patients with subfoveal choroidal neovascularization (CNV) due to AMD. Patients received intravitreal injections (1.25 mg) of bevacizumab and were monitored monthly with determination of best-corrected ETDRS visual acuity and OCT for persistence of retinal thickening. Eyes were retreated on an "as needed" basis, defined by presence of intraretinal or subretinal fluid. Patients were monitored every 2 months to 3 months for persistence of angiographic leakage.
  
  
  RESULTS
  Seventy-nine eyes of 74 consecutive patients received the initial injection of bevacizumab between August 1, 2005, and January 30, 2006. Sixty-eight eyes (86%) of 64 patients had at least 3 months of follow-up. Mean central retinal thickness +/- SD decreased from 304 +/- 83 microm at baseline to 237 +/- 105 microm at 3 months (P = 0.00002). Mean ETDRS visual acuity gained 4 letters from 20/100 at baseline to 20/80-1 at 3 months (P = 0.040). Twenty eyes (25%) appeared to have a sustained response to a single injection and did not require further injections through 3 months. Two patients had a potentially drug-related adverse event (ischemic stroke and myocardial infarction). No serious injection-related adverse events occurred.
  
  
  CONCLUSIONS
  Intravitreal bevacizumab injection affects a rapid decrease in retinal thickness to normal or near-normal levels and improvement in visual acuity in eyes with CNV due to AMD. The sustainability of changes in retinal thickness and visual acuity in response to bevacizumab treatment warrant further investigation and long-term follow-up.
authors.affiliation: Macular Degeneration Center, Casey Eye Institute, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: M Vaughn
authors.initials: MV
authors.lastname: Emerson
authors.forename: Andreas K
authors.initials: AK
authors.lastname: Lauer
authors.forename: Christina J
authors.initials: CJ
authors.lastname: Flaxel
authors.forename: David J
authors.initials: DJ
authors.lastname: Wilson
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Francis
authors.forename: J Timothy
authors.initials: JT
authors.lastname: Stout
authors.forename: Geoffrey G
authors.initials: GG
authors.lastname: Emerson
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Schlesinger
authors.forename: Susan K
authors.initials: SK
authors.lastname: Nolte
authors.forename: Michael L
authors.initials: ML
authors.lastname: Klein
mesh_terms: D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011379:Prognosis; D012160:Retina / Q000187:drug effects / Q000473:pathology; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab