Changes in retinal sensitivity in patients with neovascular age-related macular degeneration after systemic bevacizumab (avastin) therapy.
OBJECTIVE
To evaluate changes in central retinal sensitivity in patients with neovascular age-related macular degeneration after systemic bevacizumab (Avastin; Genentech, Inc., South San Francisco, CA) therapy.


METHODS
For all eyes, the central 12 x 12 degrees visual field was recorded using the MP 1 Microperimeter (Nidek, Gamagori, Japan) at baseline and 1 week, 1 month, 3 months, and 6 months after initial treatment. Patients received systemic anti-vascular endothelial growth factor (VEGF) therapy with three initial bevacizumab infusions at 2-week intervals. Retreatment during follow-up was performed only in cases of choroidal neovascularization recurrence. Seven patients (12 eyes) received bevacizumab infusions at a dose of 5 mg/kg, and 7 patients (9 eyes), at a dose of 2.5 mg/kg.


RESULTS
Of 41 stimulation points, a mean absolute scotoma of 15 missed stimulation points was measured at baseline, which decreased to 10 missed stimulation points at month 3 (-5; P = 0.005) and to 11 stimulation points at month 6 (-4; P = 0.106). The mean absolute scotoma size (in % of total tested area) decreased from 33% to 22% (-11%; P = 0.011) at month 3 and to 23% (-10%, P = 0.123) at month 6. Mean differential light threshold increased significantly throughout the observation period from 3.8 dB at baseline to 5.5 dB (+1.7 dB; P = 0.012) at month 6.


CONCLUSIONS
Systemic bevacizumab therapy induced a significant increase in mean retinal sensitivity at month 6 of follow-up and a significant decrease of mean absolute scotoma size at month 3. The MP 1 Microperimeter proved to be a valuable tool in the evaluation of functional benefits and retinal safety of anti-VEGF therapy with systemic bevacizumab.
Prager
Franz
F
Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria.
Michels
Stephan
S
Simader
Christian
C
Geitzenauer
Wolfgang
W
Schmidt-Erfurth
Ursula
U
D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008268:Macular Degeneration / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D011446:Prospective Studies; D012160:Retina / Q000502:physiology*; D019233:Retreatment; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014785:Vision, Ocular / Q000502:physiology; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab