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S. M. Michels, G. Weigert, W. Geitzenauer, S. Sacu, V. Alina, U. Schmidt-Erfurth; Intravitreal Bevacizumab (Avastin®) Therapy versus Verteporfin Therapy and Intravitreal Triamcinolone for Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):1820.
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To compare functional and anatomic outcomes of intravitreal Bevacizumab (Avastin®) and verteporfin therapy combined with intravitreal triamcinolone in patients with neovascular age-related macular degeneration (AMD)
Twenty-eight patients with neovascular AMD were enrolled in a prospective, randomized, controlled clinical trial. The protocol was approved by the ethics committee at the Medical University Vienna and was registered at the European Clinical Trial Database. All patients randomized to 1 mg of intravitreal bevacizumab (0.04ml) received 3 initial treatments at 4 weeks intervals. In further follow-up retreatment was based on optical coherence tomography (OCT). Patients randomized to standard verteporfin therapy received a same day intravitreal injection of 4mg triamcinolone (Kenalog ®). Retreatment was based on fluorescein angiography (FA) at 3 months intervals. Functional and anatomic results were evaluated using the Early Treatment Diabetic Retinopathy study (ETDRS) protocol vision charts, FA and OCT.
Baseline characteristics were comparable for both groups with regard to visual acuity (ETDRS), central retinal thickness (CRT) and CNV subtyp. At month 3 visual acuity increased in the bevacizumab group from 49.6 ± 17.6 letters (~ 20/100) at baseline to 58.8 ± 19.4 letters (~20/63) and decreased slightly in the verteporfin and intravitreal triamcinolone treated group from 40.5 ± 15.9 (~20/160) to 38.6 ± 21.3 (~20/160-1). Both groups showed similar results with regard to reduction in central retinal thickness (CRT) as measured by OCT. At month 3 CRT was reduced in the bevacizumab treated group from 358µm to 225µm and in the verteporfin and intravitreal triamcinolone treated group from 328µm to 213µm.
Intravitreal bevacizumab showed promising short-term results in patients with neovascular AMD. Functional results appear not only to be dependent on reduction in CRT but also on the treatment modality used.
European Clinical Trial Database No 2005-003132-21
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