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R. S. Newsom, K. C. Madhusudhana, S. R. Hannan1, C. P. R. Williams, S. Goverdhan, C. Rennie, A. J. Lotery, A. J. Luff; Intravitreal Bevacizumab (Avastin) for the Treatment of Neovascular Age-Related Macular Degeneration: Results From 118 Cases. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3360.
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To evaluate the safety and efficacy of intravitreal bevacizumab as treatment for neovascular age-related macular degeneration (AMD).
A retrospective chart review of 115 patients (118 eyes) treated with intravitreal bevacizumab 1.25 mg for choroidal neovascularisation (CNV) secondary to AMD was performed. Clinical examination, best-corrected visual acuity, fundus fluorescein angiography and optical coherence tomography were performed at baseline and follow-up visits.
All patients had sub-foveal CNV except three who had peripapillary CNV. In total, 219 injections were given (mean number of injections per patient= 1.86). Follow-up averaged 4.6 months (range: 1- 9 months). At baseline, the mean visual acuity score (ETDRS letters) was 48.5. At 1, 3 and 6 months follow-ups, the mean visual acuity scores improved to 54 (P= 0.05), 54.5 (P=0.01) and 54.1 (P=0.09) respectively. At final follow-up, 22.8% of eyes achieved ≥15 letters improvement, 65.2% had stable vision (loss or gain of <15 letters) and 11.9% lost ≥ 15 letters of vision. The mean central macular thickness reduced from 346.3 µm at baseline to 259.6 µm at final follow-up (P < 0.0001). Two patients suffered ocular side effects but no systemic adverse effects were noted.
Intravitreal bevacizumab appears to be safe and effective in patients with CNV secondary to AMD. Randomised controlled trials are warranted to confirm these findings and to establish the optimal dosage for different lesion types.
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