Intravitreal injection of 2.5 mg versus 1.25 mg bevacizumab (Avastin) for treatment of CNV associated with AMD.
OBJECTIVE
To compare the safety and efficacy of intravitreal injections of 1.25 and 2.5 mg bevacizumab for treatment of choroidal neovascularization associated with age-related macular degeneration.


METHODS
In this prospective, randomized, comparative clinical trial, 86 patients with active choroidal neovascularization associated with age-related macular degeneration were studied. Baseline best-corrected visual acuity in the study eye was from 20/40 to 20/2000. Patients were randomly assigned to receive intravitreal injections of 2.5 (39 patients) or 1.25 mg (47 patients) of intravitreal bevacizumab. Best-corrected visual acuity measurement and clinical ocular examination were performed at 1 week, 1 month and then monthly for 5 months. Fluorescein angiography and optical coherence tomography were performed at 1 month and 3 months after each injection.


RESULTS
The mean change in best-corrected visual acuity was -0.06 +/- 0.3 logMAR in 1.25 mg and -0.07 +/- 0.34 in 2.5 mg groups in 3 months (P = 0.9) and -0.06 +/- 0.27 logMAR in 1.25 mg and -0.09 +/- 0.28 in 2.5 mg groups in 5 months (P = 0.6). There was no significant difference in visual acuity between the two groups at any time point during the study. The mean change in foveal thickness was -49 +/- 36 micro in 1.25 mg and -65 +/- 31 micro in 2.5 mg group (P = 0.6). In 2.5 mg group, three cases of vitreous reaction and one case of massive subretinal hemorrhage were observed.


CONCLUSIONS
Intravitreal injection of 2.5 mg bevacizumab has the same efficacy as 1.25 mg, but may be associated with a higher rate of adverse events.
Modarres
Mehdi
M
Department of Ophthalmology, Eye Research Center, Iran University of Medical Sciences, Tehran, Iran.
Naseripour
Masood
M
Falavarjani
Khalil Ghasemi
KG
Nikeghbali
Aminollah
A
Hashemi
Masih
M
Parvaresh
Mohammad Mehdi
MM
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D004305:Dose-Response Relationship, Drug; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000188:drug therapy* / Q000473:pathology / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies; D012160:Retina / Q000187:drug effects / Q000473:pathology; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A; D014792:Visual Acuity; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab