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H.L. Brooks, Jr., E.D. Ashmore, D.L. Barker; Safety And Efficacy Of Intravitreal Avastin For Neovascular Age Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):5212.
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To evaluate the short term safety and efficacy of intravitreal bevacizumab in the treatment of neovascuar age–related macular degeneration (AMD)
retrospective, noncomparative, interventional case series
Intravitreal bevacizumab injections were performed in 114 eyes for all forms of neovascular AMD. During the one month post–injection period, no adverse ocular events, including endophthalmitis, lens damage, retinal tear, or retinal detachment, were reported. Complications of systemic bevacizumab use, such as hyertension and thromboembolic events, were not noted. One patient with pre–exising hypertension, diabetes, and anti–coagulation suffered an acute cerebral hemorrhage two weeks post injection. Pre–injection visual acuities ranged from 20/20 to hand motion, with a median of 20/160. One month data reveals a median visual acuity of 20/125 and a range of hand motion to 20/20. At one month follow up, no patients experienced severe vision loss (loss of greater than 15 letters or three lines of vision). At one month, 45.6% experienced at least one line of improvement in vision. 93.9% of eyes remained stable or improved at one month (p=0.008). Preliminary two month data provides a median visual acuity of 20/142 (p=0.25). According to evaluation by clinical exam, flourescein angiography and optical coherence tomography, 23 (20%) of lesions remained active at one month. Sixteen eyes received repeat injections at one month. Six month data will be presented at the meeting.
Early results imply that intravitreal bevacizumab is an effective therapeutic alternative for all forms of neovascular AMD. One patient with high risk factors for hemorrhagic stroke died two weeks after injection. The early resolution of lesions at one month follow–up suggests that treatment with intravitreal bevacizumab may limit the number of necessary invasive procedures. Despite limited number of injections and short duration of follow up, these results support the need for more a detailed, controlled evaluation.
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