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V. Kon-Jara, M. Torres-Soriano, J. Diaz-Rubio, M. Hernandez-Rojas, J. Guerrero- Naranjo, J. Fromow-Guerra, H. Quiroz-Mercado; Efficacy of Retreatments With Bevacizumab in Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3349.
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To evaluate efficacy of retreatments with Intravitreal Bevacizumab (Avastin) to maintain or to improve visual acuity in Choroidal Neovascularization (CNV) in two regimens of treatment, one according to symptomatology and another according to an established algorithm; and to determine which protocol of treatment is better controlling disease activity.
Prospective, randomized, experimental and descriptive open-label study of 14 patients with CNV secondary to Age related Macular Degeneration that were injected with Intravitreal Bevacizumab (Avastin) 2.5 mg/0.1ml. A standardized ophthalmic evaluation was performed at baseline and at weeks 2, 6 and 12 (±1). Main outcome measures included ETDRS best corrected Visual Acuity (BCVA) at baseline, and after 2, 6 and 12 weeks respectively; Optical Coherence Tomography (OCT) and Fluorescein Angiogram (FA) at baseline, and after 6 and 12 weeks. There were 2 groups, A: Patients were treated if they had clinical, OCT or angiographic signs of activity; B: Patients were treated according to an algorithm every 6 weeks.
In Group A (7 eyes), patients presented a transient improvement during first 2 weeks with later worsening of BCVA. In Group B (7 eyes) patients presented significant clinical improvement that was sustained until the end of study.The most common adverse events were conjunctival hyperemia and subconjunctival hemorrhage at the injection site. Mean BCVA improved from baseline throughout the study (P > 0.001) in both groups. Compared with baseline, BCVA was improved at week 2, week 6 and week 12. At week 6, most of the lesions area were stable or decreased in OCT and FA.
Periodic injection of Bevacizumab every 6 weeks according to an established algorithm resulted in a better control of CNV and BCVA improvement or stabilization compared to treatment according to patient symptomatology.Abstract NIH registrationAPEC-0012
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