Intravitreal bevacizumab (avastin) for subfoveal neovascular age-related macular degeneration.
OBJECTIVE
To report the visual and anatomic outcome of intravitreal bevacizumab (Avastin) injections in the treatment of subfoveal neovascular age-related macular degeneration (AMD).


METHODS
Interventional, consecutive, retrospective case series. Sixty-five eyes of 65 patients with subfoveal neovascular age-related macular degeneration (AMD) received three intravitreal bevacizumab (1.25 mg) injections. Outcome measures included visual acuity (VA), central retinal thickness (CRT), and size of lesion at 24 or more weeks follow-up.


RESULTS
Thirty-five eyes had prior treatment with photodynamic therapy (PDT). At presentation, VA was 1.12 +/- 0.62 logMAR, CRT was 305 +/- 115 microm, and greatest linear diameter (GLD) of the lesion was 4,902 +/- 1,861 microm. There was no statistically significant difference between previous PDT and naïve eyes in VA, CRT, and GLD at presentation. After three bevacizumab injections, VA, CRT, and GLD significantly improved (P < 0.0001 in all groups). There was no statistically significant difference between CRT and GLD outcomes and subfoveal neovascular membrane type or age. Eyes with better VA at baseline and without previous PDT treatment achieved better final VA (P < 0.0001 and P = 0.045, respectively). A classic membrane type and lower age were somewhat associated with better post-treatment VA.


CONCLUSIONS
Short-term results suggest that intravitreal bevacizumab is well tolerated and associated with improvement in VA, decreased CRT, and decreased lesion size in most patients. The most important predictors of final VA outcomes were baseline VA and no previous PDT treatment. Further evaluation of intravitreal bevacizumab for the treatment of subfoveal neovascular AMD is warranted.
Levy
Jaime
J
Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel. ljaime@bgu.ac.il
Shneck
Marina
M
Rosen
Shirley
S
Klemperer
Itamar
I
Rand
David
D
Weinstein
Orly
O
Pitchkhadze
Anry
A
Belfair
Nadav
N
Lifshitz
Tova
T
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; D005260:Female; D005500:Follow-Up Studies; D005584:Fovea Centralis / Q000098:blood supply; D006801:Humans; D056965:Injections, Intraocular; D008268:Macular Degeneration / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D009389:Neovascularization, Pathologic / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D012160:Retina / Q000187:drug effects / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D014792:Visual Acuity / Q000187:drug effects; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab