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D. Pieramici, R. Avery, M.D. Rabena, A.A. Castellarin, M.A. Nasir, M.J. Guist; Bevacizumab (Avastin) in the Treatment of Neovascular Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3540.
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To report the short term safety and biologic effect of intravitreal bevacizumab(Avastin®, Genentech, Inc., South San Francisco, California) in patients with subfoveal neovascular age–related macular degeneration(AMD).
Interventional, consecutive, retrospective, case series. Patients received intravitreal bevacizumab (1.25 mg) on a monthly basis until macular edema, subretinal fluid and/or pigment epithelial detachments resolved. Ophthalmic evaluations included nonstandardized Snellen visual acuity, complete ophthalmic examination, fluorescein angiography, and ocular coherence tomography (OCT).
Eighty–one eyes of 79 patients with subfoveal neovascular AMD were included in this study. No significant ocular or systemic side effects were observed. Most patients had a reduction in retinal thickness by OCT beginning 1 week following the injection. Four weeks following the injection, 30 of 81 eyes demonstrated complete resolution of retinal edema, subretinal fluid and pigment epithelial detachments. Of the 51 eyes with 8 weeks follow–up, 25 eyes had complete resolution of retinal thickening, subretinal fluid, and pigment epithelial detachments. At 1,4,8,and 12 weeks, the mean retinal thickness of the central 1 millimeter was decreased by 61, 92, 89 and 67 microns, respectively (p<0.0001 for 1,4,and 8 weeks, and p<0.01 at 12 weeks). At 4 and 8 weeks, mean visual acuity improved from 20/200 to 20/125 (p<0.0001). The median vision improved from 20/200 to 20/80– at 4 weeks, and from 20/200 to 20/80 at 8 weeks.
Short–term results suggest that intravitreal bevacizumab (1.25 mg) is well tolerated and was associated with improvement in visual acuity, decreased retinal thickness by OCT, and reduction in angiographic leakage in most patients, the majority of whom had previous treatment with photodynamic therapy and/or pegaptanib. Further evaluation of intravitreal bevacizumab for the treatment of choroidal neovascularization is warranted.
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