title: Causes of interruption of bevacizumab therapy in age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the rate and the causes of interruption of bevacizumab intravitreal therapy in patients with exudative age-related macular degeneration (AMD) in a referential eye-care center in Joinville, southern Brazil.
  
  
  METHODS
  Retrospective, non-comparative, consecutive case series. Cases included all patients with exudative age-related macular degeneration who were treated with one or more bevacizumab intravitreal injections at Sadalla Amin Ghanem Eye Hospital between January, 2006 and January, 2008. Data were obtained from patients' medical records and telephone interviews. Discontinuity criterion was the absence of patient follow-up after a minimum of 3 months from the last ophthalmic examination.
  
  
  RESULTS
  Eighty-two patients were treated. Among them, 24 (29.3%) interrupted follow-up inadvertently. The mean age was 75.2 years old (range 65-89 yo). Mean number of bevacizumab intravitreal injections was 2.0 (range 1-6). Nineteen patients answered to telephone questionnaires. The main alleged causes of discontinuity of therapy were unexpected poor visual results (8 cases, 42.1%), lack of information about followup visits (5 cases, 26.3%) and comorbidities (3 cases, 15.8%).
  
  
  CONCLUSIONS
  A high number of patients interrupted follow-up after beginning bevacizumab therapy. Many of them related avoidable causes for discontinuity of treatment. Efforts must be done to improve education of age-related macular degeneration patients, especially in relation to functional outcomes and prolonged follow-up care.
authors.affiliation: Hospital Regional de São José Dr. Homero de Miranda Gomes, São José, SC, Brazil. reportella@hotmail.com
authors.forename: Renata Portella
authors.initials: RP
authors.lastname: Nunes
authors.forename: Mário Junqueira
authors.initials: MJ
authors.lastname: Nóbrega
authors.forename: Fernando José
authors.initials: FJ
authors.lastname: De Novelli
authors.forename: Samuel Angelo
authors.initials: SA
authors.lastname: Coral
authors.forename: Thais Bacha
authors.initials: TB
authors.lastname: Berti
authors.forename: Marina Maria Drumm
authors.initials: MM
authors.lastname: Missen
authors.forename: Marina Canuto
authors.initials: MC
authors.lastname: Correa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D056965:Injections, Intraocular; D008268:Macular Degeneration / Q000188:drug therapy*; D008297:Male; D010352:Patient Dropouts / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014822:Vitreous Body
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab