title: Is monthly retreatment with intravitreal bevacizumab (Avastin) necessary in neovascular age-related macular degeneration?
abstract: OBJECTIVE
  To report our short-term experience with bevacizumab in neovascular age-related macular degeneration (AMD) and recommend a new treatment strategy.
  
  
  METHODS
  Retrospective chart review of 29 consecutive patients receiving 1.25 mg of intravitreal bevacizumab for AMD and completing 12 weeks of follow up. Outcome measures were best corrected visual acuity (BCVA) and optical coherence tomography (OCT) central macular thickness. Injections were repeated if no further improvement was observed.
  
  
  RESULTS
  Twenty-nine eyes of 29 patients were included. The average BCVA improved from 20/148 at baseline to 20/106 at twelve weeks (P = 0.041). Of the 29 eyes, 25 (86.2%) had stable or improved BCVA. Average mean central macular thickness measured by OCT improved from 351 mum at baseline to 278 mum at 12 weeks (P = 0.003). Stabilization of vision and improved OCT central macular thickness were maintained for at least eight weeks following only a single injection in the majority of eyes. During the three months of follow up, only five eyes (17.2%) required repeat injections, with only three (10.3%) requiring retreatment at eight weeks and none at four weeks. No significant ocular or systemic side effects were observed.
  
  
  CONCLUSIONS
  This short-term data suggests that bevacizumab appears to be a safe and effective treatment for neovascular AMD. Injections as frequent as every month do not appear to be necessary since initial treatment effect appears to be maintained for at least eight weeks in almost all of our patients.
authors.affiliation: Department of Ophthalmology, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Nicola G
authors.initials: NG
authors.lastname: Ghazi
authors.forename: Tyler Q
authors.initials: TQ
authors.lastname: Kirk
authors.forename: Robert M
authors.initials: RM
authors.lastname: Knape
authors.forename: James S
authors.initials: JS
authors.lastname: Tiedeman
authors.forename: Brian P
authors.initials: BP
authors.lastname: Conway
references.citation: JAMA. 2005 Mar 23;293(12):1509-13
references.pmid: 15784876
references.citation: Am J Ophthalmol. 2006 Jul;142(1):1-9
references.pmid: 16815245
references.citation: N Engl J Med. 2004 Jun 3;350(23):2335-42
references.pmid: 15175435
references.citation: Toxicol Pathol. 1999 Sep-Oct;27(5):536-44
references.pmid: 10528633
references.citation: Retina. 2006 Mar;26(3):270-4
references.pmid: 16508425
references.citation: Ophthalmology. 2006 Mar;113(3):363-372.e5
references.pmid: 16458968
references.citation: Toxicol Sci. 1999 Nov;52(1):101-6
references.pmid: 10568703
references.citation: Retina. 2006 Mar;26(3):262-9
references.pmid: 16508424
references.citation: Am J Ophthalmol. 2006 Jul;142(1):162-4
references.pmid: 16815270
references.citation: Retina. 2006 Mar;26(3):257-61
references.pmid: 16508423
references.citation: Retina. 2006 May-Jun;26(5):495-511
references.pmid: 16770255
references.citation: Br J Ophthalmol. 2007 Feb;91(2):157-60
references.pmid: 16870653
references.citation: Retina. 2006 May-Jun;26(5):512-8
references.pmid: 16770256
references.citation: N Engl J Med. 2004 Dec 30;351(27):2805-16
references.pmid: 15625332
references.citation: Br J Ophthalmol. 2006 Nov;90(11):1344-9
references.pmid: 16854824
references.citation: Graefes Arch Clin Exp Ophthalmol. 2009 Dec;247(12):1601-8
references.pmid: 19597740
references.citation: Ophthalmology. 2005 Jun;112(6):1035-47
references.pmid: 15936441
references.citation: Retina. 2006 Apr;26(4):383-90
references.pmid: 16603955
references.citation: Ophthalmology. 2006 Apr;113(4):633.e1-4
references.pmid: 16483659