title: [Efficacy of three intravitreal injections of bevacizumab in the treatment of exudative age-related macular degeneration].
abstract: BACKGROUND
  To evaluate intravitreal bevacizumab therapy for choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
  
  
  METHODS
  A retrospective review between June 2006 and May 2008 of patients with CNV secondary to AMD was conducted. All patients were treated with intravitreal injection of bevacizumab (1.25mg) once a month during a 3-month-period. The mean evaluation criteria were the best-corrected visual acuity (BCVA) logMar testing before and one month after the third injection. All eyes underwent an angiography and an optical coherence tomography before injections to define the activity and the type of CNV and then to evaluate the persistence of leakage (macular edema, subretinal fluid, and pigment epithelial detachment) after treatment. Then treatments were left to the investigator's discretion during the following six months.
  
  
  RESULTS
  Seventy-one eyes of 66 patients were enrolled. There were 65% occult CNV, 20% classic CNV, and 15% combined. A significant improvement in BCVA was observed, from 0.88±0.57 to 0.77±0.60 (p=0.001), one month after the third injection. At this time, 57.7% of the eyes required a reinjection because of leakage persistence. A concomitant treatment with intravitreal triamcinolone injection and/or photodynamic therapy was necessary for 8% of nonresponder eyes. Six months after initial treatment, a complete resolution of exudative signs was not obtained for 33.8% of eyes. The average number of injections was 3.85±0.96 during the 9-month follow-up. BCVA stability was observed at 4, 6 and 9-month follow-ups (F(71.2)=1.54; p=0.46). Three complications occurred: one endophthalmitis, one retinal tear, and one vitreous hemorrhage secondary to a macular hemorrhage.
  
  
  CONCLUSIONS
  Mean BCVA significantly improved at one month after three consecutive monthly intravitreal injections of bevacizumab. However, most eyes required a reinjection.
  
  
  CONCLUSIONS
  In spite of improvement in BCVA, leakage of the CNV persisted in most eyes after three monthly intravitreal injections of bevacizumab. Then retreatment and sometimes concomitant treatment was necessary to obtain complete resolution of exudative signs and BCVA stability.
authors.affiliation: Service d'ophtalmologie, CHU de Dijon, 32, rue du Faubourg-Raines, BP 1519, 21033 Dijon cedex, France.
authors.forename: M L
authors.initials: ML
authors.lastname: Bidot
authors.forename: L
authors.initials: L
authors.lastname: Malvitte
authors.forename: S
authors.initials: S
authors.lastname: Bidot
authors.forename: A
authors.initials: A
authors.lastname: Bron
authors.forename: C
authors.initials: C
authors.lastname: Creuzot-Garcher
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D009877:Endophthalmitis / Q000209:etiology; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D058449:Intravitreal Injections; D008266:Macula Lutea / Q000473:pathology; D008269:Macular Edema / Q000188:drug therapy; D010778:Photochemotherapy; D010857:Pigment Epithelium of Eye / Q000187:drug effects; D012163:Retinal Detachment / Q000188:drug therapy; D012166:Retinal Hemorrhage / Q000209:etiology; D012167:Retinal Perforations / Q000209:etiology; D012189:Retrospective Studies; D058471:Subretinal Fluid / Q000187:drug effects; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage; D042461:Vascular Endothelial Growth Factor A / Q000008:administration & dosage*; D014792:Visual Acuity / Q000187:drug effects; D014823:Vitreous Hemorrhage / Q000209:etiology; D057135:Wet Macular Degeneration / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D000893:Anti-Inflammatory Agents; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D014222:Triamcinolone Acetonide