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R. A. Costa, R. Jorge, D. Calucci, L. A. S. Melo, Jr., L. Paccola, J. A. Cardillo, I. U. Scott; Intravitreal Bevacizumab (Avastin) in Combination With Verteporfin Photodynamic Therapy for Choroidal Neovascularization Associated With Age-Related Macular Degeneration (IBeVe Study). Invest. Ophthalmol. Vis. Sci. 2007;48(13):3379.
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To investigate the effects of intravitreal bevacizumab when combined with verteporfin photodynamic therapy (PDT) for the treatment of choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD).
Prospective open-label study of 11 patients with documented CNV progression after one or two treatment sessions of PDT who underwent combined PDT and intravitreal injection of 1.5mg of bevacizumab. Standardized ophthalmic evaluation was performed at baseline and at weeks 1, 2, 12 and 24. Clinical evidence of complications as well as changes in best-corrected visual acuity (BCVA) and in fluorescein leakage from CNV were evaluated.
The mean baseline logarithm of the minimum angle of resolution (logMAR) Early Treatment Diabetic Retinopathy Study (ETDRS) BCVA was 1.031 (20/200-2). At follow-up weeks 1, 2, 12 and 24, the mean logMAR ETDRS BCVA was 0.944 (20/160-2), 0.924 (20/160-1), 0.882 (20/160+1), and 0.933 (20/160-2), respectively. The change in BCVA from baseline was significant at each study follow-up interval (P < 0.001); at 12 and 24 weeks, the mean change in BCVA from baseline was an improvement of 1.49 and of 0.98 ETDRS line, respectively. Fluorescein leakage from CNV was absent in all eyes at week-12. One additional treatment session was required in seven (63.6%) eyes at week-24 due to recurrence of some fluorescein leakage (minimum, n=4; moderate, n=3) from CNV. No progression of the neovascular lesion was observed throughout the study.
The overall changes observed in vision and fluorescein leakage from CNV throughtout the study suggest that a possible synergistic effect may arise from the combination of intravitreal bevacizumab with PDT for the treatment of neovascular AMD.
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