title: Intravitreal bevacizumab for subfoveal choroidal neovascularization in age-related macular degeneration at twenty-four months: the Pan-American Collaborative Retina Study.
abstract: OBJECTIVE
  To report the 24-month anatomic and Early Treatment Diabetic Retinopathy Study (ETDRS) best-corrected visual acuity (BCVA) response after primary intravitreal bevacizumab (IVB) (Avastin; Genentech Inc., San Francisco, CA) (1.25 or 2.5 mg) in patients with subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
  
  
  METHODS
  Retrospective, multicenter, interventional, comparative case series.
  
  
  METHODS
  We reviewed the clinical records of 180 consecutive patients (207 eyes) with subfoveal CNV secondary to AMD at 9 centers from 8 countries.
  
  
  METHODS
  Patients were treated with at least 1 injection of IVB 1.25 mg (124 eyes [59.9%]) or 2.5 mg (83 eyes [40.1%]). Patients underwent ETDRS BCVA testing, ophthalmoscopic examination, optical coherence tomography (OCT), and fluorescein angiography (FA) at baseline and 1-, 3-, 6-, 12-, and 24-month visits.
  
  
  METHODS
  Changes in BCVA and OCT.
  
  
  RESULTS
  The mean age of our patients was 74.3±7.5 years. The mean number of IVB injections per eye was 5.1 (range, 1-24 injections). In the 1.25 mg group, baseline BCVA improved from 20/235 (logarithm of the minimum angle of resolution [logMAR] 1.07) to 20/172 (logMAR 0.92) at 24 months (P<0.0001). Similar BCVA changes were observed in the 2.5 mg group. At baseline, the mean central macular thickness (CMT) by OCT in the 1.25 mg group was 308.4±127.52 μm, which was reduced to 269.35±97.92 μm, 262.1±94.81 μm, 264.03±97.06 μm, 245.91±89.52 μm, and 249.27±89.14 μm at 1, 3, 6, 12, and 24 months, respectively (P<0.0001). Similar changes were observed in the 2.5 mg group. In the 2.5 mg group, systemic complications included 2 new cases (2.6%) of arterial hypertension, 1 case (1.3%) of stroke, and 1 case (1.3%) of death.
  
  
  CONCLUSIONS
  Primary IVB at a dose of 1.25 or 2.5 mg seems to provide stability or improvement in BCVA, OCT, and FA in subfoveal CNV secondary to AMD at 24 months. Our results show no significant difference regarding BCVA with IVB at doses of 1.25 or 2.5 mg.
authors.affiliation: Retina and Vitreous Service, Clinica Oftalmológica Centro Caracas, Caracas, Venezuela. arevalojf2020@gmail.com
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Arevalo
authors.forename: Juan G
authors.initials: JG
authors.lastname: Sánchez
authors.forename: Lihteh
authors.initials: L
authors.lastname: Wu
authors.forename: Maria H
authors.initials: MH
authors.lastname: Berrocal
authors.forename: Arturo A
authors.initials: AA
authors.lastname: Alezzandrini
authors.forename: Natalia
authors.initials: N
authors.lastname: Restrepo
authors.forename: Mauricio
authors.initials: M
authors.lastname: Maia
authors.forename: Michel E
authors.initials: ME
authors.lastname: Farah
authors.forename: Miguel
authors.initials: M
authors.lastname: Brito
authors.forename: Manuel
authors.initials: M
authors.lastname: Díaz-Llopis
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Rodríguez
authors.forename: Guillermo
authors.initials: G
authors.lastname: Reategui
authors.forename: Juan
authors.initials: J
authors.lastname: Iturralde-Iraola
authors.forename: Patricia
authors.initials: P
authors.lastname: Udaondo-Mirete
mesh_terms: 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* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005584:Fovea Centralis; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; 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