title: Intravitreal bevacizumab in the management of neovascular age-related macular degeneration: effect of baseline visual acuity.
abstract: OBJECTIVE
  To study prospectively the safety and efficacy of intravitreal bevacizumab for eyes with neovascular age-related macular degeneration with baseline visual acuity better than 70 letters (Snellen equivalent better than 20/40).
  
  
  METHODS
  Patients with treatment-naive neovascular age-related macular degeneration were categorized prospectively into three groups according to baseline visual acuity: Group 1 (better than 70 letters), Group 2 (70 to 61 letters), and Group 3 (60 to 51 letters). Best-corrected visual acuity and central retinal thickness using optical coherence tomography were measured at baseline and at each follow-up visit. Intravitreal bevacizumab was administered according to an as-needed optical coherence tomography-guided regimen. Main outcome measure was mean best-corrected visual acuity for each group at 12 months.
  
  
  RESULTS
  Each group included 30 patients (30 eyes). Improvement in central retinal thickness was similar among the 3 groups (P = 0.964). Mean letter gain in visual acuity at 12 months was +0.4, +3.8, and +4.2 for Groups 1, 2, and 3, respectively (P = 0.42). Mean best-corrected visual acuity at 12 months was 78.4 letters for Group 1, 70.0 letters for Group 2, and 61.1 letters for Group 3 (P < 0.001). All eyes in Group 1 (100%) avoided losing 15 letters of best-corrected visual acuity versus 83.3% in Group 2 and 80.0% in Group 3. This difference was significant only between Group 1 and Group 3 (P = 0.02).
  
  
  CONCLUSIONS
  Intravitreal bevacizumab for eyes with neovascular age-related macular degeneration and baseline visual acuity better than 70 letters was safe and able to maintain this vision over 12 months.
authors.affiliation: *Department of Ophthalmology, American University of Beirut, Beirut, Lebanon; †Department of Public Health, Weill Cornell Medical College, Doha, Qatar; and ‡Department of Ophthalmology, Hotel Dieu de France, Saint Joseph's University, Beirut, Lebanon.
authors.forename: Georges M
authors.initials: GM
authors.lastname: El-Mollayess
authors.forename: Ziyad
authors.initials: Z
authors.lastname: Mahfoud
authors.forename: Alexandre R
authors.initials: AR
authors.lastname: Schakal
authors.forename: Haytham I
authors.initials: HI
authors.lastname: Salti
authors.forename: Dalida
authors.initials: D
authors.lastname: Jaafar
authors.forename: Ziad F
authors.initials: ZF
authors.lastname: Bashshur
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011446:Prospective Studies; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000187:drug effects* / Q000502:physiology; D057135:Wet Macular Degeneration / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab